Background:Data on trace elements in Infantile tremor syndrome (ITS) is sparse. The aim of the present study was to evaluate micronutrient status in children with ITS using ICP-MS.

Methodology:A cross-sectional study was carried out in a tertiary care hospital in North India from July 2016 to Dec 2017. Children less than 3 years with developmental delay, history of predominant breast feeding and skin pigmentation were included. Alternate diagnosis during follow up and prior exposure to supplementation were excluded. Their developmental history, anthropometry and complete blood count, Vitamin B12, homocysteine and micronutrient levels were measured. The cases’ mothers sample as well as age-matched controls with their mothers’ samples were also taken. Trace elements were measured using ICP-MS.

Results:Fifty-eight children were screened and 26 were enrolled with 19 controls. The proportion of MCV >95fL among the cases (17%) vs the controls (0) was significant (p<0.001). Sixty-eight percent cases enrolled, had low vitamin B12 levels as compared to five percent in controls (p<0.001). Elevated homocysteine (>15) was seen in 96% (n=23) of cases (p<0.001). Serum homocysteine was also elevated between the two maternal groups (p =0.008). Eight controls had hypoferritinemia, while none with ITS had it (p<0.001). None of the children in either group had low serum levels of zinc and magnesium. Low levels of selenium were seen in six cases and five controls. This was statistically comparable.

Conclusion:The present study found an association of markers of B-12 deficiency and ITS. However, it didn't find any between the studied micronutrients and ITS.