{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,21]],"date-time":"2025-12-21T13:46:35Z","timestamp":1766324795910,"version":"3.48.0"},"reference-count":12,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,11,21]]},"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:p>A toddler attended our emergency department with fever and cough. She was pale with mild work of breathing and an otherwise normal respiratory examination. She had intermittent vomiting, previously attributed to a cow\u2019s milk protein allergy, and was noted to be failing to thrive with faltering weight gain. She was found to have a severe iron deficiency anaemia. Chest radiograph showed a right mediastinal mass, confirmed on CT as a right posterior congenital diaphragmatic hernia (CDH).<\/jats:p>\n                  <jats:p>Iron deficiency resolved with supplementation. She had an uneventful elective surgical repair and straightforward recovery. Her weight gain improved significantly post-surgery.<\/jats:p>\n                  <jats:p>Late presentation of CDH can be challenging to diagnose as it can present with a variety of non-specific, acute or chronic symptoms and may also be incidental. It should be considered as a possible diagnosis in children presenting with severe unexplained iron deficiency anaemia and\/or poor weight gain.<\/jats:p>","DOI":"10.1136\/bcr-2025-268996","type":"journal-article","created":{"date-parts":[[2025,12,21]],"date-time":"2025-12-21T13:45:23Z","timestamp":1766324723000},"page":"e268996","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Failure to thrive: a delayed presentation of congenital diaphragmatic hernia"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5020-6635","authenticated-orcid":false,"given":"Jonathan","family":"Kong","sequence":"first","affiliation":[{"name":"Department of Paediatrics, University College London Hospitals NHS Foundation Trust, London, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henry","family":"White","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, University College London Hospitals NHS Foundation Trust, London, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Eisen","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, University College London Hospitals NHS Foundation Trust, London, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasmin","family":"Baki","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, University College London Hospitals NHS Foundation Trust, London, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,12,21]]},"reference":[{"key":"2025122105451762000_18.12.e268996.1","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1186\/s40748-017-0045-1","article-title":"Congenital Diaphragmatic hernia - a review","volume":"3","author":"Chandrasekharan","year":"2017","journal-title":"Matern Health Neonatol Perinatol"},{"key":"2025122105451762000_18.12.e268996.2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.2010.02025.x"},{"key":"2025122105451762000_18.12.e268996.3","doi-asserted-by":"crossref","first-page":"430","DOI":"10.5505\/tjh.2012.92609","article-title":"Severe iron deficiency anemia due to late presentation of congenital diaphragmatic hernia in a toddler","volume":"29","author":"Sarper","year":"2012","journal-title":"Turk J Haematol"},{"key":"2025122105451762000_18.12.e268996.4","doi-asserted-by":"publisher","DOI":"10.1136\/adc.88.6.532"},{"key":"2025122105451762000_18.12.e268996.5","doi-asserted-by":"crossref","first-page":"e128","DOI":"10.1097\/PEC.0000000000001302","article-title":"Congenital Diaphragmatic Hernia in a Child With Abdominal Pain and Respiratory Distress","volume":"33","author":"Sanh","year":"2017","journal-title":"Pediatr Emer Care"},{"key":"2025122105451762000_18.12.e268996.6","doi-asserted-by":"publisher","DOI":"10.1097\/PEC.0b013e31814b2e02"},{"key":"2025122105451762000_18.12.e268996.7","doi-asserted-by":"crossref","DOI":"10.1136\/archdischild-2011-300174","article-title":"Late-presenting congenital diaphragmatic hernia","volume":"96","author":"Zachariasse","year":"2011","journal-title":"Arch Dis Child"},{"key":"2025122105451762000_18.12.e268996.8","doi-asserted-by":"publisher","DOI":"10.1136\/adc.64.11.1542"},{"key":"2025122105451762000_18.12.e268996.9","doi-asserted-by":"publisher","DOI":"10.3349\/ymj.2013.54.5.1143"},{"key":"2025122105451762000_18.12.e268996.10","doi-asserted-by":"publisher","DOI":"10.1177\/0009922810363784"},{"key":"2025122105451762000_18.12.e268996.11","doi-asserted-by":"crossref","first-page":"132","DOI":"10.35339\/ic.4.3.132-135","article-title":"Iron deficiency anemia in child with left-sided diaphragmatic hernia (case report)","volume":"4","author":"Gonchar","year":"2017","journal-title":"IC"},{"key":"2025122105451762000_18.12.e268996.12","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1007\/s13312-010-0031-4","article-title":"Diaphragmatic hernia presenting as gastrointestinal bleeding","volume":"47","author":"Zaki","year":"2010","journal-title":"Indian Pediatr"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-268996","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,21]],"date-time":"2025-12-21T13:45:24Z","timestamp":1766324724000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-268996"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12]]},"references-count":12,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,12,21]]},"published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1136\/bcr-2025-268996"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-268996","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12]]}}}