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December 2, 1974

Idiopathic Hypoproteinemia in Twins

Author Affiliations

University of Texas Medical School Houston
University of Minnesota Hospitals Minneapolis

JAMA. 1974;230(9):1257-1258. doi:10.1001/jama.1974.03240090017012

To the Editor.—  Since the report of an edema-anemia-hypoproteinemia symptom complex in infants with cystic fibrosis (by Billie and Vahlquist Acta Pediatr 44:435, 1955), several articles have been published similar to that of Lee et al (228:585, 1974). We have also participated in the care of identical male twins with this interesting symptom complex and would like to comment on them.

Report of Cases.—Case 1.—  A 2,724-gm (6-lb) boy was born to unrelated parents following an uncomplicated 39-week gestation. Neonatal course was uncomplicated, and he was breast-fed without difficulty. Following the institution of milk supplementation, however, a diffuse, macular, erythematous rash appeared and a soy formula was given. One week later, he was "swollen and pale," and oral iron therapy was started. He did not improve, however, and at 4 weeks of age was pale and edematous. Vital signs were normal for age except for the marked pallor, edema,