Internal Medicine

0521779407-14 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:16

952 Marasmus Marfan’s Syndrome

follow-up

During Rx

■Blood pressure

■Serum sodium, chloride, potassium, magnesium, phosphorus, cal-

cium, and glucose

Routine

■Weight

■Albumin or pre-albumin

■Transferrin

■CBC

complications and prognosis

Common Complications

■Progressive weight loss and lethargy: 100% if no intervention

■Delayed physical rehabilitation

■Decubitus ulcers: common, especially in non-ambulatory

■Increased infections

■Impaired wound healing

■Increased pneumonitis and urinary tract infections

■Decreased response to chemotherapy and radiotherapy: common in

■Immunosuppressed patients

Prognosis

■Without nutrition intervention, complications proceed in a cascad-

ing manner, resulting in death due to overwhelming infection and/or

■respiratory failure.

■With immediate nutrition support, full recovery is possible.

MARFAN’S SYNDROME

MICHAEL WARD, MD

history & physical

History

■abnormal posture, long limbs, hyperextensible

■myopia

■cardiac murmur, congestive heart failure

■family history of same (autosomal dominant), but 25% are new muta-

tions

Signs and Symptoms

■tall (>95th percentile)