Refeeding syndrome is a metabolic disturbance that occurs as a result of reinstitution of nutrition in people and animals who are starved, severely malnourished, or metabolically stressed because of severe illness. When too much food or liquid nutrition supplement is eaten during the initial four to seven days following a malnutrition event, the production of glycogen, fat and protein in cells may cause low serum concentrations of potassium, magnesium and phosphate. Cardiac, pulmonary and neurological symptoms can be signs of refeeding syndrome. The low serum minerals, if severe enough, can be fatal. Cause
Any individual who has had a negligible nutrient intake for many consecutive days and/or is metabolically stressed from a critical illness or major surgery is at risk of refeeding syndrome. Refeeding syndrome usually occurs within four days of starting to re-feed. Patients can develop fluid and electrolyte imbalance, especially hypophosphatemia, along with neurologic, pulmonary, cardiac, neuromuscular, and hematologic complications.During fasting, the body switches its main fuel source from carbohydrates to fat tissue fatty acids and amino acids as the main energy sources. The spleen decreases its rate of red blood cell breakdown thus conserving red blood cells. Many intracellular minerals become severely depleted during this period, although serum levels remain normal. Importantly, insulin secretion is suppressed in this fasting state, and glucagon secretion is increased.During refeeding, insulin secretion resumes in response to increased blood sugar, resulting in increased glycogen, fat, and protein synthesis. Refeeding increases the basal metabolic rate.
His bone age was appropriate for his age.The third and final case was the youngest brother of the three, a 2-year old infant boy. He weighed 2962 grams at birth and he was found to have heart murmur when he was 3 months old. Physical examination done on him in May 1986 showed a height of 63 cm, a weight of 5.3 kg, and a head circumference of 41.5 cm. His skin color, hair color and facial features were the same as his siblings. His heart murmur was found to be a grade 3/6 systolic murmur that could be heard in his lower left sternal border, after cardiac echography and other tests, the murmur was ruled out to be benign and harmless. He was noted to have ankyloglossia and hypospadias. He was also found to have whorls and loops in his fingerprints just like his siblings (5 and 5, respectively). A karyotype done on him gave back normal results. Physical examination done on him a year later in May 1987 showed a height of 73.9 cm, a weight of 8.8 kg, and a head circumference of 47.4 cm. He could control his head at the age of 6 months but even at the age of 18 months he was found to have a walking delay and a speech delay. Routine laboratory tests and bone age examination turned back normal.The authors of the condition concluded that this combination of symptoms was probably inherited in an autosomal recessive manner. == References ==