Author: Jones, M et al
Source: J Pediatric Gastroenterology and Nutrition 2001. 33(5); 602-605.
This article is a case report on a 3 year- old boy who was fed solely by a gastrostomy tube (G-tube), who developed nutrient deficiencies. He developed symptoms of bleeding gums, irritability and a rash, which are suspicious for vitamin C, vitamin A and zinc deficiencies. It was also found that he had multiple fractures when a skeletal film was completed.
He had medical history of cerebral palsy, developmental delay and a seizure disorder. He had minimal movement and did not communicate verbally. He had had a G-tube placed 8 months prior to the development of his symptoms. Because he often had severe vomiting associated with his feedings, he was placed on an elemental formula of Neocate One Plus at a calculated calorie level for his weight and height. Of interest, his weight was at the 50th% on the growth chart for his age. He had been taking a multivitamin daily, but had stopped it about 10 months prior to the symptoms appearing, as it was thought it could be contributing to his vomiting.
Blood was drawn to see if the symptoms the boy had were nutrient-related. Lab values did show that he had a severely low level of vitamin C and low levels of Vitamin A and zinc in his blood. Once the symptoms were recognized as being nutrition-related, he was treated with vitamin C and a multivitamin. Within 3 days, the symptoms improved and within 1 month the fractures had begun to heal.
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