No countermeasures have been established against horizontal infection in non-vaccinated children. We reported about siblings with different clinical courses of HBV paternal infection. To eradicate HBV, we should encourage HBV vaccination of all children and HBV infection screening of fathers and other family members.

We experienced refeeding syndrome (RFS) with an eating disorder and distal renal tubular acidosis (dRTA). A low body mass is high-risk factors for RFS development. Therefore, frequently measurement of serum phosphorus levels at the initiation of nutrition and rapid administration of phosphate preparations are required to prevent RFS-related organ failure.