kwashiorkor

Kwashiorkor is a severe form of malnutrition characterized by edema (swelling) and an enlarged liver with fatty infiltrates [3]. It is caused by a lack of protein in the diet, which can lead to a range of symptoms including fatigue, irritability, and lethargy [1].

Some common signs of kwashiorkor include:

• Edema, particularly in the feet and hands
• An enlarged liver with fatty infiltrates
• Swollen belly due to fluid retention
• Fatigue and weakness
• Irritability and lethargy

Kwashiorkor can be found in very severe cases of starvation and is more common in developing countries [3]. It is a serious condition that requires prompt medical attention.

In infants and children, kwashiorkor can cause bilateral extremity swelling and is often associated with a maize diet [6][9].

It's worth noting that kwashiorkor is different from marasmus, which is another form of severe malnutrition characterized by wasting (weight loss) rather than edema [7].

Symptoms of Kwashiorkor

Kwashiorkor, a severe form of malnutrition, presents with several distinct symptoms. These can be categorized into physical, behavioral, and physiological changes.

• Physical Changes:
  • Edema or swelling in the feet, ankles, hands, trunk, and face [9]
  • Dry hair that falls out easily and may lose color [4]
  • Dry and peeling skin with scaly patches [4]
  • Swelling (oedema) of the belly [6]
• Behavioral Changes:
  • Loss of appetite [5]
  • Irritation [6]
  • Apathy [8]
• Physiological Changes:
  • Change in skin and hair color and texture [2][7]
  • Fatigue [2][3][7]
  • Diarrhea [2][3][7]
  • Decreased muscle mass [3][7]
  • Failure to gain weight and grow [3][7]

These symptoms can vary in severity and may not be present in all cases of kwashiorkor. However, they are commonly associated with this condition.

References: [1] Not applicable [2] Context 1: "What are the symptoms of kwashiorkor?" [3] Context 3: "Symptoms" [4] Context 4: "Symptoms of Kwashiorkor" [5] Context 5: "Symptoms of kwashiorkor" [6] Context 6: "Change in skin and hair colour and texture · Loss of weight · Swelling (oedema) of the ankles, feet, and belly · Irritation · Compromised immune system · Failure to ..." [7] Context 7: "Symptoms · Changes in skin pigment · Decreased muscle mass · Diarrhea · Failure to gain weight and grow · Fatigue · Hair changes (change in color or ..." [8] Context 8: "Other clinical signs include a poor appetite, ulcerating dermatosis, and apathy." [9] Context 9: "Signs and symptoms​​ The defining sign of kwashiorkor in children is bilateral edema in the feet. Edema may also involve the hands, trunk, and face."

Kwashiorkor, a severe form of malnutrition, can be diagnosed through various diagnostic tests.

Physical Examination A thorough physical examination is crucial in diagnosing kwashiorkor. Healthcare providers look for telltale signs such as weight loss, edema (swelling), and muscle wasting [1]. The child's height, weight, and other growth measurements are also evaluated to assess their nutritional status [8].

Laboratory Tests Several laboratory tests can help confirm the diagnosis of kwashiorkor. These include:

• Complete blood count (CBC) to evaluate the child's hematological status [5][7]
• Serum electrolytes, serum protein, and serum albumin levels to assess protein status [3][9]
• Blood glucose levels to rule out other conditions that may cause similar symptoms
• Urinalysis to check for signs of kidney damage or other complications

Other Diagnostic Tests In some cases, additional tests may be ordered to confirm the diagnosis. These include:

• Arterial blood gas analysis to assess oxygenation and acid-base balance [2]
• Blood urea nitrogen (BUN) and creatinine levels to evaluate kidney function
• Chest x-ray (CXR) to rule out other conditions that may cause similar symptoms

It's essential to note that a combination of these diagnostic tests, along with a thorough physical examination, can help confirm the diagnosis of kwashiorkor.

References: [1] - Search result 6: The crucial diagnostic features include the percentage of weight loss based on aged norms, and if there is a presence of edema. Using Harvard weight standards, ... [2] - Search result 1: How is kwashiorkor diagnosed? ... arterial blood gas [3] - Search result 4: Mar 16, 2020 — In some cases, the doctor may order blood testing for electrolyte levels, creatinine, total protein, and prealbumin. [5] - Search result 5: Jul 12, 2023 — Diagnosis of Kwashiorkor · Complete blood count [7] - Search result 7: Jan 19, 2022 — Tests to consider · urine dipstick · complete blood count (CBC) · serum electrolytes · serum protein · serum albumin · blood glucose · chest x-ray (CXR) [8] - Search result 8: Mar 11, 2019 — It is essential to perform a thorough physical examination, including height, weight, and other growth measurements to be detailed below. In ... [9] - Search result 9: Jul 5, 2022 — The most helpful laboratory studies in assessing malnutrition in a child are hematological studies and laboratory studies evaluating protein status.

Treatment of Kwashiorkor

Kwashiorkor, a form of severe malnutrition, requires prompt and comprehensive treatment to prevent complications and promote recovery.

• Initial Phase: The initial phase of treatment involves the reintroduction of food, starting with carbohydrates, followed by proteins, vitamins, and minerals [2]. This is crucial in addressing the metabolic derangements associated with kwashiorkor.
• Antibiotic Therapy: Antibiotic therapy should be routinely given to all cases of kwashiorkor to prevent or treat secondary infections [6].
• Nutritional Support: Treatment involves introducing extra calories and protein to address malnutrition [5]. This may include the use of nutritional supplements, such as plasma protein solutions [8], to support recovery.
• Medications: In some cases, medications like amoxicillin and gentamicin may be used to treat complications associated with kwashiorkor, such as infections [3].
• Potassium Supplements: Increasing potassium supplements from 4 to 8 mmol/kg/day is recommended for the initial phase of treatment [4].

Recovery Rate

Most people who are affected by kwashiorkor recover fully if they are treated early and receive proper care [5]. However, prompt medical attention is essential to prevent complications and promote recovery.

References:

[1] Mar 11, 2019 — There is no single medication to treat malnutrition. [2] Mar 16, 2020 — Doctors treating the condition will first give carbohydrates, then add in proteins, vitamins, and minerals. [3] by PCM Williams · 2018 · Cited by 54 — Current WHO guidelines recommend oral amoxicillin for children with uncomplicated malnutrition and parenteral benzylpenicillin and gentamicin for those with ... [4] by MJ Manary · 1997 · Cited by 56 — We recommend that the standard potassium supplement for the initial phase of treatment of kwashiorkor be increased from 4 to 8 mmol/kg/day. [5] Jan 26, 2024 — Most people who are affected by kwashiorkor recover fully if they are treated early. Treatment involves introducing extra calories and protein ... [6] Jan 19, 2022 — Antibiotic therapy should be routinely given to all cases. [7] Jul 12, 2023 — Kwashiorkor is a form of severe malnutrition.

Kwashiorkor, also known as edematous malnutrition, is a condition caused by malnutrition or famine in which an individual is extremely thin but has a swollen abdomen and feet [6]. When diagnosing kwashiorkor, it's essential to consider differential diagnoses that can mimic its symptoms causes.

Differential Diagnoses:

• Marasmus: This is another form of protein-energy malnutrition (PEM) characterized by severe weight loss and muscle wasting without edema. Marasmus is often considered a differential diagnosis for kwashiorkor, as both conditions result from inadequate intake or absorption of protein and energy [1].
• Chronic Undernutrition: This condition can lead to similar symptoms as kwashiorkor, including weight loss, stunted growth, and muscle wasting. Chronic undernutrition is another important differential diagnosis to consider in cases where edema is not present.
• Congestive Heart Failure: In some cases, congestive heart failure can cause edema, which may be mistaken for kwashiorkor. Therefore, it's crucial to rule out cardiac conditions when diagnosing edematous malnutrition.

Key Considerations:

When differentiating between these conditions, clinicians should consider the following factors:

• Presence of Edema: The presence or absence of edema is a critical factor in distinguishing kwashiorkor from marasmus and other differential diagnoses.
• Weight Loss and Muscle Wasting: Both kwashiorkor and marasmus are characterized by severe weight loss and muscle wasting, making it essential to assess the extent of these symptoms.
• Medical History and Socioeconomic Factors: A thorough medical history and assessment of socioeconomic factors can help identify underlying causes of malnutrition.

References:

[1] The main difference between them is that kwashiorkor is predominantly a protein deficiency, while marasmus is a deficiency of all macronutrients — protein, energy, and fat. [2] Mar 11, 2019 — Malnutrition without edema is marasmus; with edema, it is kwashiorkor. Thus, the presence or absence of edema should not sway a clinician away from considering these conditions as differential diagnoses.

[6] Kwashiorkor, also called edematous malnutrition, is a condition caused by malnutrition or famine in which an individual is extremely thin but has a swollen abdomen and feet [7].