A RARE PRESENTATION OF INFANTILE TREMOR SYNDROME: OVERCOMING MALNUTRITION AND INFECTIONS IN A PAEDIATRIC PATIENT

Abstract

Infantile Tremor Syndrome (ITS) is a rare neuro-nutritional disorder observed in young children, characterized by tremors, malnutrition, and developmental regression. This case report details a 4-year-old female patient weighing 5.2 kg, who was admitted due to recurrent vomiting, refusal to consume solid food, and progressive skin peeling. A physical examination revealed hyperpigmented patches, exfoliation, and erosions on the scalp, trunk, and extremities, along with mucosal lesions indicative of zinc deficiency. Developmental assessment indicated delayed milestones, such as poor neck control and an inability to stand or walk, suggesting the presence of coexisting cerebral palsy. The patient was diagnosed with ITS complicated by severe malnutrition and dermatological symptoms resembling acrodermatitis enteropathica. Management strategies included nutritional rehabilitation utilizing an F-75 diet, supplementation with zinc and multivitamins, antifungal treatment (fluconazole syrup), topical mupirocin for skin protection, and ophthalmic intervention for corneal opacity. Significant clinical improvement was noted following supplementation and supportive care. This case underscores the necessity of early identification, thorough nutritional evaluation, and multidisciplinary management-including pharmacological, dietary, and counseling interventions—for children with ITS. Pharmacists are crucial in ensuring the appropriateness of drug therapy, preventing drug-nutrient interactions, and educating caregivers for long-term disease prevention and nutritional recovery. Early detection and integrated management are vital for enhancing outcomes in ITS and preventing recurrence.