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Definition

Kwashiorkor is a form of malnutrition that occurs when there is not enough protein in the diet.

Alternative Names

Protein malnutrition; Protein-calorie malnutrition; Malignant malnutrition

Causes, incidence, and risk factors

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 often occurs during a drought or other natural disaster, or during political unrest. These conditions are responsible for a lack of food, which leads to malnutrition.

Kwashiorkor is very rare in children in the United States. There are only isolated cases. However, one government estimate suggests that as many as 50% of elderly people 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 usually a sign of child abuse and severe neglect.

Symptoms
  • Changes in skin pigment
  • Decreased muscle mass
  • Diarrhea
  • Failure to gain weight and grow
  • Fatigue
  • Hair changes (change in color or texture)
  • Increased and more severe infections due to damaged immune system
  • Irritability
  • Large belly that sticks out (protrudes)
  • Lethargy or apathy
  • Loss of muscle mass
  • Rash (dermatitis)
  • Shock (late stage)
  • Swelling (edema)
Signs and tests

The physical examination may show an enlarged liver (hepatomegaly) and general swelling.

Tests may include:

Treatment

Getting more calories and protein will correct kwashiorkor, if treatment is started early enough. However, children who have had this condition will never reach their full potential for height and growth.

Treatment depends on the severity of the condition. People who are in shock need immediate treatment to restore blood volume and maintain blood pressure.

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 are essential.

Since the person will have been without much food for a long period of time, eating can cause problems, especially if the calories are too high at first. Food must be reintroduced slowly. Carbohydrates are given first to supply energy, followed by protein foods.

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.

Expectations (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.

Complications
  • Coma
  • Permanent mental and physical disability
  • Shock
Calling your health care provider

Call your health care provider if your child has symptoms of kwashiorkor.

Prevention

To prevent kwashiorkor, make sure the diet has enough carbohydrates, fat (at least 10 percent of total calories), and protein (12 percent of total calories).

References

Heird WC. Food insecurity, hunger, and undernutrition. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 43.

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Definition

Kwashiorkor is a form of malnutrition that occurs when there is not enough protein in the diet.

Alternative Names

Protein malnutrition; Protein-calorie malnutrition; Malignant malnutrition

Causes, incidence, and risk factors

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 often occurs during a drought or other natural disaster, or during political unrest. These conditions are responsible for a lack of food, which leads to malnutrition.

Kwashiorkor is very rare in children in the United States. There are only isolated cases. However, one government estimate suggests that as many as 50% of elderly people 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 usually a sign of child abuse and severe neglect.

Symptoms
  • Changes in skin pigment
  • Decreased muscle mass
  • Diarrhea
  • Failure to gain weight and grow
  • Fatigue
  • Hair changes (change in color or texture)
  • Increased and more severe infections due to damaged immune system
  • Irritability
  • Large belly that sticks out (protrudes)
  • Lethargy or apathy
  • Loss of muscle mass
  • Rash (dermatitis)
  • Shock (late stage)
  • Swelling (edema)
Signs and tests

The physical examination may show an enlarged liver (hepatomegaly) and general swelling.

Tests may include:

Treatment

Getting more calories and protein will correct kwashiorkor, if treatment is started early enough. However, children who have had this condition will never reach their full potential for height and growth.

Treatment depends on the severity of the condition. People who are in shock need immediate treatment to restore blood volume and maintain blood pressure.

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 are essential.

Since the person will have been without much food for a long period of time, eating can cause problems, especially if the calories are too high at first. Food must be reintroduced slowly. Carbohydrates are given first to supply energy, followed by protein foods.

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.

Expectations (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.

Complications
  • Coma
  • Permanent mental and physical disability
  • Shock
Calling your health care provider

Call your health care provider if your child has symptoms of kwashiorkor.

Prevention

To prevent kwashiorkor, make sure the diet has enough carbohydrates, fat (at least 10 percent of total calories), and protein (12 percent of total calories).

References

Heird WC. Food insecurity, hunger, and undernutrition. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 43.

Alderman H, Shekar M. Nutrition, food security, and health.In: Kliegman RM,Behrman RE, Jenson HB, Stanton BF, eds.Nelson Textbook of Pediatrics.19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 43.

Reviewed By

Review Date: 02/01/2012

Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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Related questions

What are the sources of kwashiorkor?

Kwashiorkor (Protein malnutrition) is not a disease that it transmitted. Kwashiorkor is caused by a lack of protein in the diet.


What is protein's deficiency disease?

Protein deficiency is very dangerous and can lead to death.


How could you fight kwashiorkor?

Increase the population's protein intake to prevent kwashiorkor.


Is kwashiorkor infectious?

No, Kwashiorkor is not infectious. It is a disease that results from malnutrition in less developed countries.


Kwashiorkor causes muscles to waste away and bellies to protrude What causes kwashiorkor?

Starvation (lack of protein)


How does ascaris cause kwashiorkor?

Kwashiorkor is a protein deficiency disease. Ascarids (a type of parasitic worm) feeds off protein, denying it to the person, who then gets Kwashiorkor. I should say that it is unlikely that ascarids would, on their own, cause Kwashiorkor. It would be in the context of other contributary factors as well.


Whichtype of lab test suggest for kwashiorkor?

which type of lab test suggest for kwashiorkor Or what are the lab test for kwashiokor disease?


Who discovered kwashiorkor?

Victor Daunemigha


What is Kwashiorkor?

Kwashiorkor is a form of malnutrition caused by inadequate(not enough) protein intake in the presence of fair to good energy (total calories) intake. Kwashiorkor is a condition of malnutrition characterized by a swollen belly. Kwashiorkor is severe protein malnutrition, especially in children. It is more common in impoverished parts of Africa and Asia than anywhere else.


What diseases are caused by protein dificiecy?

Kwashiorkor


Why is kwashiorkor less common in the UK?

because it is


What is the difference between malnutrition maramus and kwashiorkor?

kwashiorkor is a syndrome due to severe protien deficiency whereas maramus (marasmus) is a syndrome due to a deficiency in both protien and calories.