title: The changing profile of infantile tremor syndrome in hilly terrain of India.
abstract: BACKGROUND
  Infantile tremor syndrome (ITS) is characterized by anemia, skin pigmentation, tremors, physical, and mental regression without a defined etiopathogenesis and low incidence.
  
  
  METHODS
  We have studied 9 patients over 1 year for the changing clinical and laboratory variables of patients with ITS. Neuroregression and anemia were presented in all followed by tremors in 5 and hypotonia in 2.
  
  
  RESULTS
  Sepsis screen was positive in 6 and urine cultures in 2. Antibiotics were required in 6. ITS with changing parameters still significantly contributes to healthcare burden.
  
  
  CONCLUSIONS
  It is important to screen for urinary infection and septicemia to avoid antibiotic abuse.
authors.affiliation: Department of Pediatrics, Dr. Rajendra Prasad Government Medical College and Hospital, Tanda, Himachal Pradesh, India.
authors.forename: Deeksha A
authors.initials: DA
authors.lastname: Singla
authors.affiliation: Department of Pediatrics, Dr. Rajendra Prasad Government Medical College and Hospital, Tanda, Himachal Pradesh, India.
authors.forename: Milap
authors.initials: M
authors.lastname: Sharma
authors.affiliation: Department of Pediatrics, Dr. Rajendra Prasad Government Medical College and Hospital, Tanda, Himachal Pradesh, India.
authors.forename: Seema
authors.initials: S
authors.lastname: Sharma
authors.affiliation: Department of Orthopedics, Dr. Rajendra Prasad Government Medical College and Hospital, Tanda, Himachal Pradesh, India.
authors.forename: Vipin
authors.initials: V
authors.lastname: Sharma
keywords: Anemia; infantile; lethargy; regression; tremors; urinary tract infection