Infantile Tremor Syndrome: Time for ‘Rethink’ and a ‘Relook’

A BSTRACT Infantile tremor syndrome (ITS) is a clinical condition characterized by pallor, pigmentary changes in skin and hair, developmental regression, hypotonia, and tremors mostly described in children between 6 and 24 months of age. Of the various etiological factors that have been implicated till now, vitamin B12 deficiency has gained most ground. It has mostly been described as a benign condition responding well to vitamin B12 and other micronutrient supplementation. We describe two cases of ITS admitted in a critical condition, through which we intend to highlight two unusual aspects of this condition. First, ITS may not always be associated with ’tremor’. Second, one needs to be aware of the potential life-threatening consequence of this seemingly benign condition.