title: 'Refeeding syndrome' in a Kuwaiti child: clinical diagnosis and management.
abstract: OBJECTIVE
  To report a case of refeeding syndrome in a Kuwaiti child, its clinical presentation and management.
  
  
  METHODS
  A 13-month-old Kuwaiti boy presented with acute severe malnutrition in the form of marasmic kwashiorkor. On admission, blood sugar and serum electrolytes were normal but on the 3rd day he developed typical biochemical features of refeeding syndrome in the form of hyperglycemia, severe hypophosphatemia, hypokalemia, hypocalcemia and hypomagnesemia. The child then received treatment appropriate for refeeding syndrome in the form of lower calorie intake with gradual increase, as well as supplementation of electrolytes, thiamine and vitamins and he eventually made a safe recovery.
  
  
  CONCLUSIONS
  This case showed that during rehabilitation of a malnourished child, a severe potentially lethal electrolyte disturbance (refeeding syndrome) can occur. Careful monitoring of electrolytes before and during the refeeding phase was needed and helped to detect this syndrome early. We suggest that slow and gradual calorie increase in the 'at-risk' patient can help prevent its occurrence.
authors.affiliation: Department of Pediatrics, Sabah Hospital, Kuwait City, Kuwait. isharkawy@hotmail.com
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Al Sharkawy
authors.forename: Dina
authors.initials: D
authors.lastname: Ramadan
authors.forename: Amira
authors.initials: A
authors.lastname: El-Tantawy
mesh_terms: D006801:Humans; D007223:Infant; D007730:Kuwait; D007732:Kwashiorkor / Q000628:therapy*; D008297:Male; D055677:Refeeding Syndrome / Q000175:diagnosis* / Q000628:therapy*; D014883:Water-Electrolyte Imbalance / Q000175:diagnosis / Q000178:diet therapy