Objective: To study clinical profile in Infantile Tremor Syndrome (ITS). To estimate Vitamin B12 levelsin infantile tremor syndrome.

Methods: An observational study done in all children presenting with typical features of ITS, admitted at a tertiary care centre. Where we examined the patients and an electronic database of 25 ITS patients were prepared between November 2019 to February 2022.

Results: Out of 25 newly diagnosed ITS cases, serum vitamin B12 levels were low in 100% of casesrest clinical findings as below.

Clinical findings & Percentage of patients

Tremors 52%

Decreased Activity 28%

Malnutrition 68%

Developmantal Delay 48%

Neurodevelopmental Regression 28%

Hepatomegaly 36%

Splenomegaly 4%

Hepatomegaly And Splenomegaly 12%

Hypotonia 28%

Knuckle Pigmentation 100%

Sparse & Golden Hair 64%

Pallor 100%

Lower Respiratory Tract Infectrion 52%

Shock 28%

Conclusion: ITS should be considered in any child <3 years presenting with anaemia, developmental delay/regression, skin hyperpigmentation changes and sparse golden-brown hair, with or without tremors, with depressed activity. ITS should be excluded in any child presenting with neuro-regression, as it is important to treat condition to prevent long-term neurodevelopmental sequelae. As per NFHS [National Family Health Survey (NFHS)–V (2019-20)] survey, anaemia is widespread in India--67.1% of children, 64% of nonpregnant women and 53% of pregnant women were found to be anaemia in 2016. India carries the highest burden of the disease despite having an anaemia control programme for 50 years. Is Vitamin B12 deficiency found in these 25 cases pointing towards a larger picture, does INDIA as whole needs an aggressive Vitamin B12 supplementation programme.

Shailesh Khadabadi is a consultant pediatric hematologist and oncologist based in Belagavi, India. He holds an MBBS from PDMMC Amravati, an MD in Pediatrics from VPMC Nashik, and an FPHO fellowship (MUHS) from CTC PHO BMT Mumbai, supplemented by specialized observerships at Tata Memorial Hospital and NIIH (KEM, Mumbai).

With over seven years of experience in pediatrics and more than four years dedicated to pediatric hematology and oncology, he has managed over 200 pediatric leukemia and solid tumor cases, performed numerous bone marrow procedures, and gained hands-on experience in over 70 pediatric bone marrow transplants. He is also a specialist in managing hundreds of patients with thalassemia, sickle cell disease, hemophilia, benign hematological disorders, and pediatric immune deficiencies.

Professionally, he currently serves as a consultant pediatric hematologist oncologist at the Belagavi Institute of Medical Sciences and has previously worked at KLE cancer hospital. In addition to his clinical practice, he has contributed to medical research, including publishing an original article on the clinical profile of infantile tremor syndrome in the Sri Lanka Journal of Child Health (2026), and has actively presented research at various national conferences.