Kwashiorkor is a form of
Protein malnutrition; Protein-calorie malnutrition; Malignant malnutrition
Causes, incidence, and risk factors
Kwashiorkor is most common in areas where there is:
- 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
- Changes in
- Decreased muscle mass
- Failure to gain weight and grow
- Hair changes (change in color or texture)
- Increased and more severe infections due to damaged immune system
- Large belly that sticks out (protrudes)
- Loss of muscle mass
- Rash (dermatitis)
- Shock (late stage)
- Swelling (
Signs and tests
Tests may include:
Arterial blood gas BUN Complete blood count(CBC) Creatinine clearance Serum creatinine Serum potassium Total proteinlevels Urinalysis
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
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 (
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.
- Permanent mental and physical disability
Calling your health care provider
Call your health care provider if your child has symptoms of kwashiorkor.
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).
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.