KWASHIORKOR

By : Mutiara Riahna Sitepu (03012179)

Definition
Kwashiorkor is a form of protein-energy malnutrition
(PEM)that occurs when there is not enough protein in
the diet
The World Health Organization (WHO)

defines malnutrition as
"a cellular imbalance between
supply of nutrients and energy
and the bodys demand for them to
ensure growth, maintenance,
and specific functions
Etiology

Causes of kwashiorkor other than

protein-deficient diet :
poor intestinal absorption
chronic alcoholism
kidney disease
infections
trauma (burns)
that lead to an increase need of
protein and caloric intake and results in
loss of protein due to the body's
demand to repair.
Epidemiology
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)

 Kwashiorkor is very rare in children in
the United States. There are only
isolated cases.

When kwashiorkor does occur in the

United States, it is usually a sign of child
abuse and severe neglect.
Symptomps

Changes in skin pigment

Decreased muscle mass
Diarrhea
Failure to gain weight and grow
Hair changes (change in color or texture)
Increased and more severe infections
due to damaged immune system
Irritability
 Large belly that sticks out
Lethargy or apathy
Loss of muscle mass
Rash
Shock
Swelling (edema)
Diagnosis
The physical examination may show an enlarged liver
(hepatomegaly) and general swelling.
Tests may include:
Arterial blood gas

BUN

Complete blood count (CBC)

Creatinine clearance

Serum creatinine

Serum potassium

Total protein levels

Urinalysis
Theraphy And Treatment
Getting more calories and protein will
correct kwashiorkor, if treatment is
started early enough

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.
 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