Kwashiorkor
Protein malnutrition; Protein-calorie malnutrition; Malignant malnutritionKwashiorkor is a form of malnutrition that occurs when there is not enough protein in the diet.
Malnutrition
Malnutrition is the condition that occurs when your body does not get enough nutrients.
Read Article Now Book Mark ArticleProtein
Proteins are the building blocks of life. Every cell in the human body contains protein. The basic structure of protein is a chain of amino acids. ...
Read Article Now Book Mark ArticleCauses
Kwashiorkor is most common in areas where there is:
- Famine
- Limited food supply
- Low levels of education (when people do not understand how to eat a proper diet)
This disease is more common in very poor countries. It may occur during:
- Drought or other natural disaster
- Political unrest
These events often lead to a lack of food, causing malnutrition.
Kwashiorkor is rare in children in the United States. There are only isolated cases. However, one government estimate suggests that as many as half of older age people living in nursing homes in the United States do not get enough protein in their diet.
When kwashiorkor does occur in the United States, it is most often a sign of child abuse and severe neglect.
Child abuse
Child physical abuse is a serious problem. Here are some facts:Most children are abused at home or by someone they know. They often love this perso...
Read Article Now Book Mark ArticleSymptoms
Symptoms include:
- Changes in skin pigment
Skin pigment
Melanin is a natural substance that gives color (pigment) to: HairSkinThe iris of the eye It is produced by cells in the skin called melanocytes. Mel...
Read Article Now Book Mark Article - Decreased muscle mass
- Diarrhea
- Failure to gain weight and grow
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Fatigue
Fatigue
Fatigue is a feeling of weariness, tiredness, or lack of energy.
Read Article Now Book Mark Article - Hair changes (change in color or texture)
- Increased and more severe infections due to damaged immune system
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Irritability
Irritability
Young children who cannot talk yet will let you know when something is wrong by acting fussy or irritable. If your child is fussier than usual, it c...
Read Article Now Book Mark Article - Large belly that sticks out (protrudes)
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Lethargy or apathy
Lethargy
Fatigue is a feeling of weariness, tiredness, or lack of energy.
Read Article Now Book Mark Article - Loss of muscle mass
- Rash (dermatitis)
- Shock (late stage)
- Swelling (edema)
Edema
Swelling is the enlargement of organs, skin, or other body parts. It is caused by a buildup of fluid in the tissues. The extra fluid can lead to a ...
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Exams and Tests
The physical exam may show an enlarged liver (hepatomegaly) and general bodily swelling.
Physical exam
During a physical examination, a health care provider checks your body to determine if you do or do not have a physical problem. A physical examinati...
Read Article Now Book Mark ArticleHepatomegaly
Enlarged liver refers to swelling of the liver beyond its normal size. Hepatomegaly is another word to describe this problem. If both the liver and ...
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Arterial blood gas
Arterial blood gas
Blood gases are a measurement of how much oxygen and carbon dioxide are in your blood. They also determine the acidity (pH) of your blood.
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BUN
BUN
BUN stands for blood urea nitrogen. Urea nitrogen is what forms when protein breaks down. A test can be done to measure the amount of urea nitrogen ...
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Complete blood count (CBC)
Complete blood count
A complete blood count (CBC) test measures the following:The number of white blood cells (WBC count)The number of red blood cells (RBC count)The numb...
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Creatinine clearance
Creatinine clearance
The creatinine clearance test helps provide information about how well the kidneys are working. The test compares the creatinine level in urine with...
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Serum creatinine
Serum creatinine
The creatinine blood test measures the level of creatinine in the blood. This test is done to see how well your kidneys are working. Creatinine in t...
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Serum potassium
Serum potassium
This test measures the amount of potassium in the fluid portion (serum) of the blood. Potassium (K+) helps nerves and muscles communicate. It also ...
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Total protein levels
Total protein
The total protein test measures the total amount of two classes of proteins found in the fluid portion of your blood. These are albumin and globulin...
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Urinalysis
Urinalysis
Urinalysis is the physical, chemical, and microscopic examination of urine. It involves a number of tests to detect and measure various compounds th...
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Treatment
People who start early treatment can recover fully. The goal is to get more calories and protein into their diet. Children with the disease cannot reach their complete height and growth.
Calories are given first in the form of carbohydrates, simple sugars, and fats. Proteins are started after other sources of calories have already provided energy. Vitamin and mineral supplements will be given.
Carbohydrates
Carbohydrates are one of the main nutrients in our diet. They help provide energy for our body. There are three main types of carbohydrates found i...
Read Article Now Book Mark ArticleSimple sugars
Carbohydrates are one of the main nutrients in our diet. They help provide energy for our body. There are three main types of carbohydrates found i...
Read Article Now Book Mark ArticleFood must be restarted slowly since the person has been without much food for a long period of time. Suddenly eating high-calorie foods can cause problems.
Many malnourished children will develop intolerance to milk sugar (lactose intolerance). They will need to be given supplements with the enzyme lactase so that they can tolerate milk products.
Lactose intolerance
Lactose is a type of sugar found in milk and other dairy products. An enzyme called lactase is needed by the body to digest lactose. Lactose intoler...
Read Article Now Book Mark ArticleEnzyme
Enzymes are complex proteins that cause a specific chemical change. For example, they can help break down the foods we eat so the body can use them....
Read Article Now Book Mark ArticlePeople who are in shock need treatment right away to restore blood volume and maintain blood pressure.
Outlook (Prognosis)
Getting treatment early generally leads to good results. Treating kwashiorkor in its late stages will improve the child's general health. However, the child may be left with permanent physical and mental problems. If treatment is not given or comes too late, this condition is life threatening.
Possible Complications
Complications may include:
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Coma
Coma
Decreased alertness is a state of reduced awareness and is often a serious condition. A coma is the most severe state of decreased alertness from whi...
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Shock
Shock
Shock is a life-threatening condition that occurs when the body is not getting enough blood flow. Lack of blood flow means the cells and organs do n...
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When to Contact a Medical Professional
Contact your health care provider if your child has symptoms of kwashiorkor.
Prevention
To prevent kwashiorkor, make sure your diet has enough carbohydrates, fat (at least 10% of total calories), and protein (12% of total calories).
References
Ashworth A. Nutrition, food security, and health. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 57.
Manary MJ, Trehan I. Severe malnutrition. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 197.
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Kwashiorkor symptoms - illustration
Kwashiorkor is a condition resulting from inadequate protein intake. Early symptoms include fatigue, irritability, and lethargy. As protein deprivation continues, one sees growth failure, loss of muscle mass, generalized swelling (edema), and decreased immunity. A large, protuberant belly is common. The incidence of kwashiorkor in children in the United States is extremely small and it is typically found in countries where there is drought and famine.
Kwashiorkor symptoms
illustration
-
Kwashiorkor symptoms - illustration
Kwashiorkor is a condition resulting from inadequate protein intake. Early symptoms include fatigue, irritability, and lethargy. As protein deprivation continues, one sees growth failure, loss of muscle mass, generalized swelling (edema), and decreased immunity. A large, protuberant belly is common. The incidence of kwashiorkor in children in the United States is extremely small and it is typically found in countries where there is drought and famine.
Kwashiorkor symptoms
illustration
Review Date: 2/17/2024
Reviewed By: Charles I. Schwartz, MD, FAAP, Clinical Assistant Professor of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, General Pediatrician at PennCare for Kids, Phoenixville, PA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.