PEDIATRIC MALNUTRITION INDICATORS


MICRONUTRIENT EXAM: CLINICAL INTERPRETATION OF NUTRITION FOCUSED PHYSICAL EXAM FINDINGS


Micronutrient Exam: Clinical Interpretation of Nutrition Focused Physical Exam Findings


SIGNS/SYMPTOMS HAIR


Alopecia patchy hair loss, baldness


Hair loss


easily plucked with no pain; dull, dry, lackluster; thinning


Deficiency: Zinc • Biotin • Iron* (with or without anemia)


Toxicity: Vitamin A


Deficiency: Essential fatty acid • Riboflavin Other: Malnutrition^ Toxicity: Selenium • Vitamin A


Depigmentation; color changes; premature graying Deficiency: Copper* Other: Malnutrition^


Flag sign


alternating horizontal bands of dark and light color in hair, lack of melanin


Lanugo very fine, soft hair


Corkscrew and swan neck hair Kinky hair


Hirsutism


excessive growth of dark or coarse hair in women—face, chest, abdomen, back


Other: Malnutrition^ • Starvation (i.e., anorexia nervosa)


Deficiency: Vitamin C N/A


N/A


Non–nutrition-related cause: Menkes syndrome caused by ATP7A gene mutation that affects copper metabolism Typically in males with life expectancy of 3 years old


Possible non–nutrition-related causes: Polycystic ovary syndrome • Cushing syndrome • Adrenal hyperplasia • Androgen-secreting tumors • Chemotherapy • Medications


Other: Malnutrition^


At risk for alopecia: Asthma • Thyroid disease • Atopic dermatitis • Psoriasis • Vitiligo • Rheumatoid arthritis • Irritable bowel disease • Lupus • Down syndrome • Hereditary


Possible non–nutrition-related causes: Aging • Over-processing of hair (eg, excess bleaching) • Chemotherapy or radiation to the head • Stress of illness • Hormonal changes • Endocrine disorders • Medications • Thyroid disease


Possible non–nutrition-related causes: Chemotherapy • Hereditary


POSSIBLE NUTRITION-RELATED CAUSES ADDITIONAL INFORMATION


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