Kwashiorkor is a severe case of malnutrition in children, in which there is extreme protein deficiency. It occurs in infants after weaning, when they are put on a diet which lacks animal proteins. It is a common medical issue in underdeveloped countries, especially seen in infants in war-torn regions or inhabiting shanty towns. Kwashiorkor is marked by hypoalbuminemia (low levels of albumin in the blood), anemia, edema, depigmentation of the skin, potbelly, and loss of hair or change in hair color. Postmortem examination shows atrophy of the acinar cells of the pancreas, hyalinization of the renal glomeruli, as well as pathological liver changes, such as fatty alteration in hepatocytes (liver cells). The consequence of this extreme malnutrition is growth retardation and low IQ (intelligence quotient).
Children suffering from kwashiorkor are prone to acquire bacterial pneumonia, tuberculosis, bacterial meningitis, and septicemia due to their immunodeficiency (low levels of neutrophils -granulocytic white blood cells- and lymphocyte T and B). Kwashiorkor is isually found in the tropics and subtropics (Central and South America, Africa, India) but also in the Middle East. It appears most often once the children are weaned and are transferred to a vegetable diet consisting principally of carbohydrates. The development of the condition may be fostered by infection (tuberculosis, pneumonia, malaria, helminthic diseases), difficult living conditions, and a low standard of living. Kwashiorkor leads to a significant retardation of physical development. The skin becomes dry and scaly. It takes on a reddish tint, and cracks and ulcers may appear. The hair becomes lighter in color and falls out easily.
Kwashiorkor also leads to a total loss of subcutaneous adipose tissue, with marked loss of muscle mass. Thus, there is atrophy of skeletal muscles. Dental caries develop. Edema is often observed. There is a loss of appetite and abdominal distention, and vomiting and diarrhea are frequent. Patients become irritable and apathetic. The course of the condition may be complicated by pneumonia and a decrease in the hemoglobin content of the blood. Treatment of kwashiorkor involves a proper diet and vitamin therapy and blood and plasma transfusions. The condition can be prevented by a balanced diet, which include milk, beef liver, meat, cheese, etc., a raised standard of living, and the improvement of general medical care.
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| A child suffering from malnutrition. |