Synonym(s)
Flour damage; malignant; Malnutrition syndrome; Malnutrition syndrome malignant; Protein deficiency syndrome; protein-energy malnutrition
HistoryThis section has been translated automatically.
Williams, 1933
DefinitionThis section has been translated automatically.
Severe chronic malnutrition (protein deficiency syndrome) in infants and small children (so-called infantile pellagra), especially in warm countries. Kwashiorkor is taken from the indigenous language of the African Gold Coast (Kwashi = boy; orkor = red).
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Occurrence/EpidemiologyThis section has been translated automatically.
Mainly infants in Africa, South America, West India.
EtiopathogenesisThis section has been translated automatically.
Deficit in energy metabolism due to reduced protein intake with simultaneous action of other noxious agents, infections and nutritive noxious agents, e.g. aflatoxin, are discussed. The pathogenesis is unclear in detail. Edema is not necessarily associated with hypoproteinemia.
Clinical featuresThis section has been translated automatically.
- Skin changes: Parakeratotic keratinization tendency. Inflammatory and squamous-crusty changes, especially in the diaper area, trochanteric, knees, elbows. Pressure points on the trunk, leaving out the areas of skin exposed to light. Bluish-red or reddish-brownish erythema, later clear scaling, rhagade formation in the large joint bends. Characteristic depigmentation with hypopigmentation periorbital and on the legs and early oedematous swelling. Possible hyperpigmentation after healing of the inflammatory changes. Dry, fine, easily broken, lustreless hair with a reddish-brownish colour. Ribbon-like change of normal and abnormal hair colour results in the characteristic flag-sign. In advanced cases development of dark, almost purple spots in the groin area.
- Extracutaneous manifestations: anorexia, edema especially on hands and feet, hypalbumin dysproteinemia (inconstant). Gastrointestinal disorders: diarrhoea, vomiting. Irritability, irritability, apathy. Signs of polyavitaminosis. Hepatomegaly, retardation of growth and mental development and muscular atrophy.
Differential diagnosisThis section has been translated automatically.
TherapyThis section has been translated automatically.
Protein intake through a high-protein diet.
Progression/forecastThis section has been translated automatically.
In mild cases with appropriate diet and protein intake regression. 10-30% mortality in severe and recurrent cases.
LiteratureThis section has been translated automatically.
- Alleyne GAO, Hay RW, Picou DI et al (1977) Protein-energy malnutrition. Arnold, London
- Collins S et al (2002) Outpatient care for severely malnourished children in emergency relief programmes: a retrospective cohort study. Lancet 360: 1824-1830
- Golden M (1985) The consequences of protein deficiency in man and its relationship to the features of Kwashiorkor. In: Blaxter K, Waterlow JC (eds) Nutritional adaption in man. Libbey, London, S. 169-187
- Niggemann B et al (2003) Side-effects of complementary and alternative medicine. Allergy 58: 707-716
- Williams CD (1933) A nutritional disease of childhood associated with a maize diet. Arch Dis Child 8: 423-433
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Incoming links (9)
Flag sign; Flour damage; Hair color changes; Malnutrition syndrome, malignant; marasmus; Pellagra; Protein deficiency syndrome; protein-energy malnutrition;; Protein-energy malnutrition;Disclaimer
Please ask your physician for a reliable diagnosis. This website is only meant as a reference.
Prof. Dr. med. Peter Altmeyer