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Alternative namesProtein malnutrition; Protein-calorie malnutrition; Malignant malnutrition; Mehlä hrschaden
DefinitionKwashiorkor is a form of malnutrition caused by inadequate protein intake.
Causes, incidence, and risk factors
Kwashiorkor occurs most commonly in areas of famine, limited food supply, and low levels of education, which can lead to inadequate knowledge of proper diet.
A large, protuberant belly is common. Skin conditions (such as dermatitis , changes in pigmentation, thinning of hair, and vitiligo ) are seen frequently. Shock and coma precede death.
The incidence of kwashiorkor in children in the U.S. is extremely low and only rare, isolated cases are seen.
This is typically a disease of impoverished countries, and is often seen in the midst of drought or political turmoil. However, one government estimate suggests that as many as 50% of elderly persons in nursing homes in the U.S. suffer from protein-calorie malnutrition.
Severe kwashiorkor may leave a child with permanent mental and physical disabilities. There is good statistical evidence that malnutrition early in life permanently decreases IQ.
Risk factors include living in impoverished countries, countries in political unrest, and countries affected by frequent natural disasters (such as drought). These conditions are directly or indirectly responsible for scarcity of food which leads to malnutrition.
Signs and testsThe physical examination may show an enlarged liver ( hepatomegaly ) and generalized edema .
Decreased renal function as shown by changes in:
Treatment varies depending on the severity of the condition. Shock requires immediate treatment with restoration of blood volume and maintenance of blood pressure .
Since the person will have been without much food for a long period of time, starting oral feedings can present problems, especially if the caloric density is too high at first. Food must be reintroduced slowly, carbohydrates first to supply energy, followed by protein foods.
Expectations (prognosis)Treatment early in the course of kwashiorkor generally produces good results. Treatment of kwashiorkor in its late stages will improve the child's general health, but he or she may be left with permanent physical problems and intellectual disabilities. Without treatment or if treatment comes too late, this condition is fatal.
Calling your health care providerAlthough very rare in industrialized countries, when kwashiorkor does occur in such places, it is usually a sign of child abuse and severe neglect.
PreventionAdequate diet with appropriate amounts of carbohydrate , fat (minimum of 10 percent of total calories), and protein (12 percent of total calories) will prevent kwashiorkor.
Update Date: 7/11/2002Chayim Newmark, M.D., Department of Pediatrics, St. Louis Children's Hospital, Washington University, St. Louis, MO. Review provided by VeriMed Healthcare Network.
Last updated: Tue, 06 Jan 2009 00:20:03 GMT