GI - Kwashiorkor

Question 1

Definition

Answer 1

Kwashiorkor or oedematous malnutrition is a disease marked by severe protein malnutrition and bilateral extremity swelling.

Question 2

Epidemiology

Answer 2

1 - 3 years old

Question 3

Aetiology

Answer 3

Unknown

Question 4

Risk factors

Answer 4

• Endemic food insecurity or famine
• Rural communities
• < 5 years of age
• Monotonous diet based on corn or cassava
• Weaning off breast feeding

Question 5

Presentation

Answer 5

● Bilateral pitting oedema
● Hair discolouration-Hair becomes thin, sparse, and easily pulled out, and black hair
often turns orange or reddish-brown in colour.
● Dermatosis/ulceration-Classically seen as hyper-pigmentation
● Delayed wound healing
● Hepatomegaly
● Protuberant belly

Question 6

Investigations

Answer 6

FIRST LINE = Clinical diagnosis
Consider
- FBC
- U and E’s
- LFTs
- Urea and Creatinine

Question 7

Management

Answer 7

Uncomplicated FIRST LINE: Nutritional rehabilitation Ready-to-use therapeutic feeding = (RUFTS)
+ Oral Abx
Complicated FIRST LINE: facility-based care with regular milk-based liquid food
+ Empirical Abx therapy
Consider Vit A

Question 8

Complications

Answer 8

Growth stunting
Loss of vision