A CASE REPORT: PRE INFANTILE TREMOR SYNDROME WITH SEVERE ANEMIA SECONDARY TO BLOOD LOSS IN CONGESTIVE CARDIAC FAILURE.

Infantile tremor syndrome (ITS) is a rare clinical disorder characterized by clinical syndrome coarse tremors, anaemia and regression of motor acute or gradual onset of mental and psychomotor changes; pigmentation disturbances of hair and skin, pallor, mental milestones in children of around between 5 months to 3 years of age. Exact incidence is not known. The disorder is common in exclusively breast fed infant of vegetarian mothers most of the children eventually recover but are frequently left with cognitive, language, neurodeficits and death which is associated with some life threatening disease or condition this as review attempt to provide comprehensive and up to date information on the subject. Here, an 11-month-old boy with normal development who was born to a non-consanguineous marriage was taken to the hospital with the main complaint of creeping fever since two days' worth of loose stools eight to ten times per day and three to four episodes of vomiting. On investigation Head to toe had an open anterior font, sparse hair, and hyper pigmented knuckles on the upper limbs. Additionally, the red pigment on the lips and abnormally flat or broad nails were signs of pre-ITS and severe anaemia. After starting the suggested course of treatment, the symptoms considerably improved. Child was transferred to the intensive care unit (PICU) after experiencing sudden spikes in fever, passing black tarry stool, abdominal distension, and congestive cardiac failure. The child was later diagnosed as having pre-ITS septicemia and severe anaemia secondary to bleeding in the CCF.