Abstract
Objective: To report shock and multi-system organ failure from anaemia and folate deficiency in an 11 month old girl. Design: Isolated case report. Setting: Paediatric ICU in a tertiary care referral center. Subject: 11 month old girl. Measurements and main results: Following admission to the Paediatric ICU and stabilization of cardiorespiratory function, evaluation revealed macrocytosis on the peripheral blood smear. The dietary history revealed that goat‘s milk without supplementation was the main staple of the child‘s diet. The diagnosis was confirmed by a low serum folate level. Other causes of shock and multi-system organ failure including bacterial/viral infections, toxic ingestions, and primary cardiac failure were excluded. With supportive care, the multi-system organ failure resolved. Conclusions: Although we would attribute the shock and multi-system organ failure to the severe anaemia related to folate deficiency, we cannot conclusively rule out other potential mechanisms resulting from folate deficiency at a cellular level.