PEDIATRIC MALNUTRITION INDICATORS


MICRONUTRIENT EXAM: CLINICAL INTERPRETATION OF NUTRITION FOCUSED PHYSICAL EXAM FINDINGS SIGNS/SYMPTOMS


NERVOUS SYSTEM (continued)


Seizures, memory impairment, and behavioral disturbances


Peripheral neuropathy


tingling, “pins and needles,” muscle weakness, numbness, pain, loss of reflexes


Myeloneuropathy Ataxia loss of muscle coordination Muscle weakness Deficiency: Vitamin B6 • Biotin


Deficiency: Vitamin B6 • Folate • Thiamin • Vitamin B12 • Copper • Chromium • Hypophosphatemia


Toxicity: Selenium


Deficiency: Vitamin B12 • Copper • Folate • Vitamin E


Deficiency: Vitamin B12 • Thiamin • Vitamin B6 • Biotin • Vitamin E • Copper • Manganese


Toxicity: Vitamin B6 • Manganese


Deficiency: Vitamin D • Vitamin C • Vitamin E • Vitamin B6 • Thiamin


Other: Hypophosphatemia • Hypokalemia • Hypernatremia


Tetany muscles twitching, convulsions Muscle Cramps


Muscle pain Dementia Deficiency: Vitamin D


Other: Hypocalcemia • Hypomagnesemia • Hypokalemia • Dehydration


Deficiency: Vitamin D • Vitamin C • Biotin Toxicity: Vitamin A


Deficiency: Vitamin B12 • Folate • Niacin • Biotin Other: Hyperparathyroidism with hypercalcemia


Possible non–nutrition-related cause: Alkalosis • Atherosclerosis • Lumbar stenosis • Hypothyroidism • Post-dialysis


Possible non–nutrition-related cause: Fibromyalgia


Possible non–nutrition-related causes: Disease or age related • Medications


Possible non–nutrition-related causes: Head trauma • Stroke • Cerebral palsy • Autoimmune disease (eg, multiple sclerosis, sarcoidosis, celiac disease) • Infections • Side effects of medications


Possible non–nutrition-related causes: Nerve damage • Autoimmune disease (Sjögren syndrome) • Lupus • Rheumatoid arthritis • Guillain-Barré syndrome • Chronic inflammatory demyelinating polyneuropathy and vasculitis • Diabetes mellitus • Infections • Tumors


41 POSSIBLE NUTRITION-RELATED CAUSES ADDITIONAL INFORMATION


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