Case Reports
Vol. 21 No. 1 (2025)
https://doi.org/10.4081/ecj.2024.13186

Extreme nutritional neglect leading to cardiac arrest in a child: a rare presentation of severe acute malnutrition in England

Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Received: 1 October 2024
Accepted: 7 November 2024
Published: 17 December 2024
1491
Views
506
Downloads
Case report, malnutrition, resuscitation, neglect, safeguarding

Authors

Ashley Reed
Ashleyreed@nhs.net
https://orcid.org/0000-0001-5021-6641
Consultant Practitioner in Emergency Care, Southend University Hospital, Mid and South Essex NHS Trust, United Kingdom.
Mohamed Bar
https://orcid.org/0009-0003-0809-6334
Paediatric Trainee, Southend University Hospital, Mid and South Essex NHS Trust, United Kingdom.

This case report from England describes an 8-year-old girl who suffered severe health complications culminating in cardiac arrest due to profound neglect and malnutrition. The patient presented with cardiac arrest, which was attributed to her severe wasting. Upon admission, her body mass index measured 12.8 kg/m2 (zscore ranging between -2 and -3), indicative of severe malnutrition. The patient presented with respiratory, renal, and hepatic failure, in addition to disseminated intravascular coagulation. Resuscitative measures were administered, and she underwent 162 hours of ventilation in the paediatric intensive care unit. Despite the gravity of her initial presentation, the patient exhibited a notable recovery. Paediatric cardiac arrest stemming from extreme nutritional neglect is a rare occurrence in England. This case underscores the paramount importance of prompt intervention and comprehensive medical oversight. The patient’s relatively favourable recovery underscores the potential for positive outcomes when timely and appropriate medical interventions are employed.

Downloads

Download data is not yet available.
Royal College of Paediatrics and Child Health. UK-WHO growth charts - 2-18 years. 2018.
World Health Organization. Growth Reference 5-19 Years - BMI-for-age (5-19 years). 2007.
Ons.gov.uk. Deaths from malnutrition - Office for National Statistics. 2023.
Solarino B, Tsokos M, Di Vella G, Tattoli L. Child Starvation and Neglect. In: Handbook of Famine, Starvation, and Nutrient Deprivation. 2019: pp. 961–79.
Thakur N, Chandra J, Pemde H, Singh V. Anemia in severe acute malnutrition. Nutrition 2014;30:440–2.
Langeland H, Damås JK, Mollnes TE, et al. The inflammatory response is related to circulatory failure after out-of-hospital cardiac arrest: A prospective cohort study. Resuscitation 2022;170:115–25.
Benabe JE, Martinez-Maldonado M. The Impact of Malnutrition on Kidney Function. Miner Electrolyte Metab 1997;24:20–6.
Soeters PB, Wolfe RR, Shenkin A. Hypoalbuminemia: Pathogenesis and clinical significance. J Parenter Enter Nutr 2018;43:181–93.
Arya AK, Kumar P, Midha T, Singh M. Hematological profile of children with severe acute malnutrition: a tertiary care centre experience. Int J Contemp Pediatr 2017;4:1577.
De Silva A, Nightingale JMD. Refeeding syndrome: physiological background and practical management. Frontline Gastroenterol 2019;11:404–9.
Titi-Lartey OA, Gupta V. Marasmus. [Online] PubMed. 2020.
Grantham‐McGregor S, Powell C, Walker S, et al. The long-term follow-up of severely malnourished children who participated in an intervention program. Child Dev 1994;65:428-39.
Burns J, Shank C, Ganigara M, et al. Cardiac complications of malnutrition in adolescent patients: A narrative review of contemporary literature. Ann Pediatr Cardiol 2021;14:501–6.
Das S, Rajesh Kumar Meena, Shah D, et al. Children with severe acute malnutrition have high rates of bone resorption: A cross-sectional comparative study. Nutr Res 2023;117:66–72.
Bourke CD, Berkley JA, Prendergast AJ. Immune Dysfunction as a Cause and Consequence of Malnutrition. Trends Immunol 2016;37:386–98.
Talbert A, Atkinson S, Karisa J, et al. Hypothermia in Children with Severe Malnutrition: Low Prevalence on the Tropical Coast of Kenya. J Trop Pediatr 2009;55:413–6.
Corsello A, Chiara Maria Trovato, Dipasquale V, et al. Refeeding syndrome in pediatric age, an unknown disease: A narrative review. J Pediatr Gastroenterol Nutr 2023;77:e75–83.
Galler JR, Bringas-Vega ML, Tang Q, et al. Neurodevelopmental effects of childhood malnutrition: a neuroimaging perspective. Neuroimage 2021;231:117828.
Soliman A, Sanctis V, Elalaily R. Nutrition and pubertal development. Indian J of Endocrinol Metab 2014;18:39.
Zubairu AI, Oladigbolu K, Samaila E, Elijah P. Ocular morbidity among children with protein energy malnutrition in Northwest Nigeria. J West Afr Coll Surg 2022;12:83.
Mohamed Bar, Paediatric Trainee, Southend University Hospital, Mid and South Essex NHS Trust

Paediatric Trainee, Southend University Hospital, Mid and South Essex NHS Trust, UK

How to Cite



Extreme nutritional neglect leading to cardiac arrest in a child: a rare presentation of severe acute malnutrition in England. (2024). Emergency Care Journal, 21(1). https://doi.org/10.4081/ecj.2024.13186
Copyright (c) 2024 the Author(s) Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.