Nigerian Journal of Clinical Practice

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The triad of Iron deficiency anemia, hepatosplenomegaly and growth retardation with normal serum zinc levels in a 14‑year‑old boy

GM Rwegerera, DR Joel, C Bakilana, MP Maruza


A triad of iron deficiency anemia, hepatosplenomegaly and growth retardation occurring in tandem with zinc deficiency has been reported in the past as components of either Prasad’s syndrome or hypopituitarism. There are no documented cases of such triad occurring in the presence of normal serum zinc levels. We report a case of a 14‑year‑old boy who presented with iron deficiency anemia, hepatosplenomegaly, geophagia and growth retardation with pubertal delay. Investigations ruled out hypopituitarism and coeliac disease. The patient improved dramatically and attained puberty within 15 months of intense nutritional intervention. In conclusion, iron deficiency anemia occurring in the triad without zinc deficiency as seen in this case report has not been reported before; this calls for more research to be able to explain the findings.

Key words: Growth retardation, hepatosplenomegaly, iron deficiency anemia, serum zinc

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