Journal List > Korean J Pediatr Gastroenterol Nutr > v.10(1) > 1110222

Korean J Pediatr Gastroenterol Nutr. 2007 Mar;10(1):60-65. Korean.
Published online Mar 31, 2007.
Copyright © 2007 The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition
Copper Deficient Anemia in Severe Protein-Energy Malnutrition due to Child Abuse
Sung Hwan Byun, Je Deok Jeon and Soo Hee Chang
Department of Pediatrics, Bundang Jesaeng General Hospital, Sungnam, Korea.

An unconscious 5-year-old girl was admitted to the Intensive Care Unit. She was neglected by her parents; she suffered from inadequate nutritional, medical and emotional care. The girl appeared to be emotionally detached, dehydrated and malnourished; she had edematous extremities, moderately bruised skin and brittle coarse hair. Laboratory testing showed electrolyte imbalance, anemia, pneumonia, copper deficiency, and liver dysfunction in addition to severe protein-energy malnutrition (PEM). Medical intervention was followed by improvement of most of the symptoms. During the rehabilitation phase, the patient showed a voracious appetite and gained weight too fast. The liver became enlarged and the patient developed a mild fever due to excessive nutrition. The microcytic anemia with severe PEM did not responded to iron supplementation possibly due to the copper deficiency. Addition of copper without zinc and iron helped to improve the anemia. The patient was discharged to a childcare center where she received cognitive and psychosocial therapy.

Keywords: Malnutrition; Child abuse; Anemia; Copper deficiency