- A dietary history of a monotonous single cereal-based diet with inclusion of animal-source foods less than once per week will raise suspicion of kwashiorkor.
- Diets based on corn, cassava, and rice are those most commonly associated with kwashiorkor.
- In Kwashiorkor, the letter ‘K’ is post-fixed to denote edema
- Cessation of breast-feeding in the few months before presentation is a common finding.
- There may be a history of preceding diarrhea or measles infection.
- Kwashiorkor edema starts in the feet and develops over a few days.
- Alternative Names:Protein malnutrition; Protein-calorie malnutrition; Malignant malnutrition
SIGNS & TESTS:
- Early signs of kwashiorkor present as general symptoms of malnutrition and include fatigue, irritability and lethargy.
- In malnourished subjects, secretory IgA is generally reduced. Therefore infections tend to be severe and recovery delayed.
Flag sign is seen :
- In Kwashiorkor hair is thin, dry, brittle, easily pluckable, sparse & devoid of their normal sheen.
- It becomes straight and hypopigmented.
- The colour of the hair that grows during the period of nutritional deprivation appears reddish brown.
- During the phase of better nutrition, the growing part of the hair gets appropriately pigmented.
- This gives appearance of alternate bands of hypopigmented & normally pigmented hair. This is called Flag sign.
As protein deprivation continues the following abnormalities become apparent.
- Failure to thrive (failure to put on height and weight)
- Loss of muscle mass
- Pitting oedema- This is the main sign(due to low albumin level)
- Poor appetite
- Large protuberant belly (pot belly)
- Fatty liver
- Failing immune system so prone to infections and increased severity of normally mild infections
Skin and hair changes:
- Flaky paint dermatosis
- Retarded growth
- Psychomotor changes
Tests may include:
- Arterial Blood Gas
- BUN(Blood Urea Nitrogen)
- Complete Blood Count(CBC)
- Creatinine Clearance
- Serum Creatinine
- Serum Potassium
- Total Protein Levels
- Antibiotics to treat infections
- Gradual increases in dietary calories from carbohydrates, sugars and fats
- Gradual increases in dietary protein
- Intravenous fluids to correct fluid and electrolyte imbalances
- Lactase to assist in digestion of dairy products
- Vitamin and mineral supplements to treat deficiencies
- Anemia (low red blood cell count)
- Frequent infections
- Intellectual disability
- Physical disability
- Poor wound healing
- Short stature
- Skin pigmentation changes
- Fatty liver
- Kwashiorkor can be prevented by including foods in your diet that are rich in proteins, such as
- Dairy products,
- Soya, and beans.
- Treatment involves slow increases in calories from carbohydrates, sugars, and fats, followed by protein.
- Vitamin and mineral supplements and enzymes to help digest dairy products are often needed
- Flag sign is seen in kwashiorkor
- Kwashiorkor is characterised by Markedly retarded growth, psychomotor changes,Dermatitis,Edema,Flag sign
- Apathy, Flaky paint dermatosis, Poor appetite & low albumin level is seen in Kwashiorkor
- In malnourished subjects, secretory IgA is generally reduced.
- In Kwashiorkor, the letter ‘K’ is post-fixed to denote Edema
Don’t Forget to Solve all the previous Year Question asked on Kwashiorkor