Kwashiorkor Nur Amalina Aminudddin Baki 082012100067

Shahirah aliya 63Kamalia iqma 71

Farzana 75

s_udupa@yahoo.com

Objectives

• The student should be able to:– To understand what is

kwashiorkor– To know the causes and

occurrence of kwashiorkor– To be aware of the symptoms,

biochemical manifestation , treatment and difference from marasmus

Introduction

• Protein- energy malnutrition• Disease that child gets when the next baby is born• develop after a mother weans her child from breast milk, replacing it with a diet high in carbohydrates but lack in protein.

Occurrence

• Found in children between 1 to 5

Third world countries

Low level of

education

famine

Limited food

supply

• # 1 South Africa:820 deaths • # 2 Mexico:75 deaths • # 3 Brazil:46 deaths • # 4 Venezuela:13 deaths • = 5 Peru:11 deaths • = 5 Ecuador:11 deaths • # 7 Colombia:10 deaths • # 8 United States:8 deaths • # 9 Egypt:5 deaths • = 10 Paraguay:3 deaths

Causes

Breast milk

contains

proteins

and amino

acids vital to a child's growth

Diet of a

weaning of child

mainly consist

of carbohydrates

insufficie

nt intake of

proteins

Clinical Symptoms

• Stunted growth• Diarrhea• Edema• Discoloration of hair and skin• Anemia• Protuded belly• Moonface

Biochemical Manisfestations

• Decreased plasma albumin concentration(<2g/dl, N:3-4.5)

• Diarrhea– Deficiency of K+

• Fatty liver • Edema– Lack of adequate plasma proteins to maintain water

distribution between blood and tissues• Plasma retinol binding protein is reduced• Immunological response very low

Treatment

• Carbohydrates first, then protein• Ingest protein rich foods– 3-4g of protein/kg body weight/day

• Treatment can be monitored:– using plasma albumin concentration– disappearance of edema – gain in body weight

Kwashiorkor vs. MarasmusClinical parameter Kwashiorkor Marasmus

Age of onset Pre- school (1-5 years old )

Weaned infants (<1years old)

Main nutritional cause

Low protein intake Low calorie intake

Body weight 60-80% of normal < 60% of normal

Growth Mild retardation Severe retardation

Abdomen Protruding Shrunken

Facial appearances Moonface Like old man’s face

Conclusion

• Occurs to lack of protein• Most likely occur in third world countries• Characterized by protruded belly• Can be treated with rich protein foods

Reference

• DM Vasudevan Sreekumari, Kannan Vaidyanathan, textbook of biochemistry for medical students, sixth edition,2011.

• U. Satyanarayana and U.Chakrapani, Biochemistry,3rd edition,2012

• http://www.umm.edu/ency/article/001604prv.htm