Kwashiorkor
The content of the article:
- Causes and risk factors
- Symptoms
- Diagnostics
- Treatment
- Potential consequences and prevention
- Forecast
- Prevention
Kwashiorkor (infant pellagra) is a severe form of dystrophy that usually affects children between the ages of 1 and 4, but is rarely seen in adults.
This disease was first described in 1935 by Jamaican pediatrician Cicely Williams in the Lancet.
Kwashiorkor is found in developing countries, the population of which feeds mainly on starchy vegetables. When breastfeeding, the baby receives the amino acids it needs from breast milk for normal development. But after weaning, the protein content in the baby's diet decreases sharply. The lack of amino acids leads to the fact that water begins to accumulate in the internal organs.
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Causes and risk factors
The main role in the development of the disease belongs to the insufficient content of protein, vitamins and trace elements in the diet. Causes of protein deficiency:
- the predominance of low protein foods in the diet;
- violation of protein absorption in the small intestine (exudative enteropathy, celiac disease);
- genetically determined disorders of amino acid metabolism;
- burn disease;
- severe infectious diseases;
- violations of protein synthesis, developing against the background of chronic liver diseases;
- nephrotic syndrome, accompanied by increased loss of protein in the urine.
Children need a positive nitrogen balance (a condition when the intake of protein from food exceeds its consumption and loss). Insufficient intake of protein, especially in combination with a deficiency of energy, vitamins and minerals, causes degenerative changes in organs and tissues, disrupts the growth and development of the child's body. If measures are not taken to correct nutrition, then dystrophy will increase and eventually kwashiorkor will develop.
Symptoms
Kwashiorkor develops gradually. The first symptoms of the disease are nonspecific:
- decreased tissue turgor;
- irritability or indifference;
- lethargy, weakness;
- decreased muscle tone.
A decrease in the child's body weight often goes unnoticed, since with kwashiorkor, latent protein-free edema is formed early. As the disease progresses, these edema becomes apparent.
Kwashiorkru is characterized by protein-free edema
Other symptoms of kwashiorkor include:
- layered peeling and hyperpigmentation of the skin in the area of their friction against the folds of clothing;
- thinning hair and increased hair loss;
- vomiting;
- diarrhea;
- anorexia;
- an increase in the size of the liver.
Often in patients with kwashiorkor, signs of deficiency of vitamins B and A are revealed.
Diagnostics
Diagnosis of kwashiorkor is based on clinical manifestations of the disease (muscle wasting, skin hyperpigmentation, hair fragility, puffiness, growth retardation), history data (inappropriate nutrition of the child, early weaning) and laboratory results (hypoalbuminemia, anemia).
Treatment
Diet therapy is of the greatest importance in the treatment of kwashiorkor. Nutrition correction is carried out taking into account the age needs of the child. To replace the missing protein, the diet includes protein enpits, cottage cheese, milk, amino acid preparations. Increase the energy value and protein content in the diet should be gradually, focusing on the condition of the patients. To improve the digestion and assimilation of food, enzyme preparations are prescribed. Vitamin-mineral complexes containing B vitamins, vitamin A, iron, magnesium, potassium and selenium are also prescribed.
To treat kwashiorkra, you must include protein-rich foods in your diet
In the first weeks of therapy for the disease, the weight of patients usually does not increase, but, on the contrary, decreases. This is due to a decrease in edema.
Potential consequences and prevention
Against the background of kwashiorkor, a sharp weakening of the immune system occurs. As a result, patients are susceptible to infectious diseases, as well as purulent-inflammatory complications due to the addition of a secondary infection.
In severe kwashiorkor, a disorder of the functions of the central nervous system occurs, up to the development of a coma, against the background of which death occurs.
Forecast
With timely detection and adequate treatment, the prognosis is favorable.
Prevention
Prevention of kwashiorkor consists in the proper organization of nutrition for children in the first years of life:
- breastfeeding in the first year of life;
- correct and timely introduction of complementary foods;
- inclusion in the diet of a sufficient amount of dairy and meat products.
Diseases that can lead to protein deficiency require timely treatment.
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Elena Minkina Doctor anesthesiologist-resuscitator About the author
Education: graduated from the Tashkent State Medical Institute, specializing in general medicine in 1991. Repeatedly passed refresher courses.
Work experience: anesthesiologist-resuscitator of the city maternity complex, resuscitator of the hemodialysis department.
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
