Kwashiorkor
Original Editors - Kevin Boothe from Bellarmine University's Pathophysiology of Complex Patient Problems project.
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Definition/Description[edit | edit source]
Kwashiorkor is a form of malnutrition that occurs when there is not enough protein in the diet.1 It is most often encountered in children of overpopulated developing or underdeveloped countries, where their diet consist mostly of grains and starchy vegetables, with low to minimal amounts of protein included in their diet. Common in areas of famine, limited food supply, and low levels of education.2 This diet is adequate in calories, but deficient in certain amino acids, which constituents proteins for vital growth. During nursing, the mother is able to supply the essential amino acids and proteins needed via breastfeeding. After the child is weaned from breastfeeding, their protein needs are neither met by milk or meat.3,4 The condition of kwashiorkor in children was first described in 1932. Kwashiorkor, in African dialect, means "desposed child" ("deposed" from the mother's breast by a newborn sibling) and "red boy" due to the reddish orange discoloration of the hair that is a characteristic of the disease.4
Prevalence[edit | edit source]
Kwashiorkor is most prevalent in overpopulated areas of the world in underdeveloped and developing countries, particularly in sections of Africa, Central and South America, and South Asia.3 Kwashiorkor is very rare in the United States, but does occur and is usually a sign of child abuse and neglect.1
Characteristics/Clinical Presentation[edit | edit source]
Signs, Symptoms and Characteristics:1,2,3,4
- changes in skin pigment (reddish pigmentation)
- atrophy (decreased muscle mass) of muscles and glands
- severe diarrhea
- failure to gain weight
- hair changes (change in color or texture); reddish orange color
- increased risk and severity of infections due to compromised immune system
- irritability (excessive response to a stimulus) (early sign)
- distended abdomen
- lethargy (fatigue) (early sign) or mental apathy (lack of feeling or emotion)
- enlarged liver with fatty infiltrates
- dermatitis
- shock (late stage)
- pedal edema (swelling of the feet)
- retarded development
- decreased immunity
- anorexia
- ulcerating dermatosis
Associated Co-morbidities[edit | edit source]
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Medications[edit | edit source]
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Diagnostic Tests/Lab Tests/Lab Values[edit | edit source]
Arterial Blood Gas (ABGs)
BUN (Blood Urea Nitrogen)
CBC (Complete Blood Count)
Creatinine clearance
Serum creatinine
Serum potassium
Total protein levels
Urinalysis
Etiology/Causes[edit | edit source]
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Systemic Involvement[edit | edit source]
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Medical Management (current best evidence)[edit | edit source]
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Physical Therapy Management (current best evidence)[edit | edit source]
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Alternative/Holistic Management (current best evidence)[edit | edit source]
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Differential Diagnosis[edit | edit source]
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Resources
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