An unusual cause of edema in a child with congenital heart disease post Fontan procedure

Protein Losing Enteropathy Post Fontan procedure. Protein Losing Enteropathy (PLE) is an uncommon cause of edema in children with congenital heart disease. Protein-Losing Enteropathy may be defined as excessive loss of proteins across the intestinal mucosa and is due to either a primary gastrointestinal abnormality or secondary to cardiac disease. Protein-losing enteropathy (PLE) is a rare complication of the Fontan palliation for functional single-ventricle. Although PLE occurs in about 3.5% of patients post-Fontan, it confers marked morbidity and high mortality within 5 years of diagnosis. The pathogenesis of Fontan-related PLE is not completely understood, and it is unclear why it develops in some patients post-Fontan and not others. We describe a child with Double Inlet Right Ventricle who had undergone Fontan procedure, and presented to us with generalised oedema. The child had hypoproteinaemia, the common causes for which were ruled out and was diagnosed as Protein Losing Enteropathy (PLE) related to his surgical intervention. Though, not frequently encountered it should be kept in mind as one of the causes of anasarca.

Correlates of picky eating behaviour in children and its effect on growth

Background: Picky eating is common in preschool-aged children. Children's picky eating behaviour has been linked both to being overweight and underweight. Authors objectives was to study the factors associates of picky eating behaviour on growth and nutritional status of children.Methods: A Cross-sectional study done in 200 parents of children between 1-5 year age visiting outpatient department. Picky eating behaviours were assessed using questions from children eating behaviour questionnaire.Results: In the study, the estimated prevalence rate was 25%, maximum 38% at 49 to 60 months. 26% of subjects with picky eating behaviour had height for age <-3SD (severely stunted) 38% of subjects with picky eating behaviour had weight for height <-3SD (severely wasted) as compared to only 4% in non-picky eating behaviour subjects. Low birth weight and exclusive breast feeding for less than 6 month, were found to be significant risk factor for development of picky eating behaviour, while no significant association was seen with the time of introduction of semisolid complimentary feeds.Conclusions: Picky eating is major parental concern and impacts growth of children. The children with picky eating behaviours need to be monitored for growth.