Katie Holmes' pale and gaunt appearance continues to raise questions about her health as she accompanies husband Tom Cruise on his promotional rounds.

The star's weight plummeted during her stint in the Broadway production of All My Sons, with some reports suggesting she may have dropped as much as 22lbs.

And Katie once again cut a painfully thin figure as she joined Tom on the red carpet for the premiere of Valkyrie in Rio de Janeiro, Brazil, yesterday.

Her stunning Christian Lacroix tunic dress and lashings of bright make up failed to detract attention away from her bony breast plate and non-existent cleavage, not to mention her apparent unease in the spotlight.

Katie, with husband Tom, at the Brazil premiere or Valkyrie yesterday

Those who know the actress believe that the strain of juggling her career with looking after daughter Suri is taking its toll.

One insider commented, "Katie's a hard worker, but by the end of the run (of All My Sons) she needed a break. There were times when she appeared close to tears. She was shattered."

Tom recently sparked rumours that his wife of two years was expecting a little brother or sister for Suri when he was snapped holding a protective hand over her tummy.

But there was certainly no sign of a baby bump – or any other bumps for that matter – yesterday.

See Katie's worrying disappearing act below