Publication:

Study of clinical, haematological and radiological profile of children admitted with infantile tremor syndrome to a tertiary care teaching hospital in Northern India

Background Infantile tremor syndrome (ITS) is characterized by gradual onset of mental and psychomotor changes, pigmentary disturbances in hairs and skin, pallor, tremors and neuroregression. The aim of study was to determine clinical, haematological and radiological spectrum of children admitted with infantile tremor syndrome.

Methods It was a prospective cross-sectional study done in age group of 6 months to 5 years conducted in department of pediatrics of a tertiary care medical college with duration of 18 months. Clinical, haematological and radiological profile parameters of 36 children admitted during study period with ITS were recorded as per prepared performa and analysed. Microsoft excel was used in creating database while data was analysed by using Statistical Package for Social Sciences (SPSS) version 23.0.

Results Total 36 children were enrolled in study. Mean age was 12.33±3.89 months and mostly were male (55.6%). Most (72.2%) of children belonged to lower socioeconomic status and (83.3%) were exclusively breastfed. Only 11.1% had severe acute malnutrition (SAM). 77.77% had vitamin B12 levels below normal. Progressive paleness (88.9%), delayed development (61.1%) and developmental regression (58.3%) were most common complaints reported. 63.9% had tremors at presentation. In MRI findings, poor myelination with thinning of corpus callosum (16.7%) and uniform thinning of corpus callosum with subtle hypomyelination in bilateral frontal lobes (8.3%) were major findings. In majority of children tremor disappeared in 11-15 days (30.6%) after starting treatment.

Conclusions ITS should to be considered as a differential diagnosis in an infant on exclusive breast feeding with vegetarian mother with poor weaning practices presenting with neuroregression, tremor and malnutrition with skin changes.