LIPID CHANGES ASSOCIATED WITH PSYCHOSOCIAL DWARFISM (PSD)

Abstract

Turbidity of fasting serum and a distinctive pattern of changing blood lipids was observed during the first week of hospitalization in 14 children aged 1.9-14.3 yrs with PSD. All demonstrated remarkable catch-up growth with changed environment. On day 1 (morning of admission) mean (X) fasting triglyceride (TG) was 69% and cholesterol (C) 156 mg%. Fasting sera in 11/12 were turbid without clearing after 48 hrs. During the first 4 days, serial observations in 10/11 children showed dramatic rise in TC (36-594%) with decrease to normal by day 6-8. Serum C gradually rose in 6/14 by day 6-9 (29-52%). During this time serum turbidity cleared. Paper lipoprotein electrophoresis of 10 hr fasting serum was normal except for a light chyle spectrum in 7/13 and an increased beta band in 1/13. An increase in prebeta fraction occurred on day 2-4 in 10/12. Recurrence of turbidity occurred after 15/21 parent visits, clearing again with parent-child separation. By contrast, 5 children with growth failure and protein-calorie malnutrition, 1.2-3.9 yrs, 24 children with hypopituitarism, 1.2-17.1 yrs (X TC 66 mg%; x C 182 mg%) and 16 children with other endocrine disorders undergoing similar hospital evaluations (X C 163 mg%) had clear fasting sera on day 1. No change in serum appearance, TG or C was seen in 8/8 of these followed serially during days 1-4. The presence of serum turbidity may provide a clue to diagnosis in psychologically induced growth retardation. The mechanism of this phenomenon is as yet unexplained.