Wentworth-Douglass Hospital
(603) 742-5252
Decrease (-) Restore Default Increase (+) font size
Physicians
Site Search

Kwashiorkor symptoms
Kwashiorkor symptoms


Definition:

Kwashiorkor is a form of malnutrition that occurs when there is not enough protein in the diet.



Alternative Names:

Protein malnutrition; Protein-calorie malnutrition; Malignant malnutrition



Causes, incidence, and risk factors:

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)

This disease is more common in very poor countries. It often occurs during a drought or other natural disaster, or during political unrest. These conditions are responsible for a lack of food, which leads to malnutrition.

Kwashiorkor is very rare in children in the U.S. There are only isolated cases. However, one government estimate suggests that as many as 50% of elderly people in nursing homes in the U.S. do not get enough protein in their diet.

When kwashiorkor does occur in the U.S., it is usually a sign of child abuse and severe neglect.



Symptoms:
  • Changes in skin pigment
  • Coma (late stage)
  • Decreased muscle mass
  • Diarrhea
  • Failure to gain weight and grow
  • Fatigue
  • Hair changes (change in color or texture)
  • Increased and more severe infections due to damaged immune system
  • Irritability
  • Large belly that sticks out (protrudes)
  • Lethargy or apathy
  • Loss of muscle mass
  • Rash (dermatitis)
  • Shock (late stage)
  • Swelling (edema )


Signs and tests:

The physical examination may show an enlarged liver (hepatomegaly ) and general swelling.

Tests may include:



Treatment:

Getting more calories and protein will correct kwashiorkor, if treatment is started early enough. However, children who have had this condition will never reach their full height and growth.

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.

Since the person will have been without much food for a long period of time, eating can cause problems, especially if the calories are too high at first. Food must be reintroduced slowly. Carbohydrates are given first to supply energy, followed by protein foods.

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.



Support Groups:



Expectations (prognosis):

Getting treatment early generally leads to good results. Treating kwashiorkor in its late stages will improve the child's general health. However, the child may be left with permanent physical and mental problems. If treatment is not given or comes too late, this condition is life-threatening.



Complications:
  • Coma
  • Permanent mental and physical disability
  • Shock


Calling your health care provider:

Call your health care provider if your child has symptoms of kwashiorkor.



Prevention:

To prevent kwashiorkor, make sure the diet has enough carbohydrates, fat (at least 10 percent of total calories), and protein (12 percent of total calories).



References:

Heird WC. Food Insecurity, Hunger, and Undernutrition. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Kliegman: Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 43.




Review Date: 8/1/2008
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
adam.com


Find What You Need

Events
Careers
Foundation
About Us
Contact
Directions
News
Social Media Agreement
Joint Notice
Web Privacy Policy
WDH Staff Portal

Centers & Services

Cancer Center
Cardiovascular Care
Joint Replacement
Women & Children's
Physician Offices
Other Services

Conditions & Treatments

Health Library

Support Services

Support Groups
Care-Van
Dental Center
Social Work
Food & Nutrition
Integrative Wellness
Spiritual Care
Concerns & Grievances
Homecare and Hospice

For Patients

Pay Your Bill Online
Pricing Estimates
Financial Assistance
Interpreter Services
Surgery Preparation
Medical Record Request
Advance Directives
Clinical Research & Trials

For Healthcare Professionals

Work and Life
Financial Well-Being
Career and Growth

The Wentworth-Douglass Health System includes:

 

Address

Wentworth-Douglass Hospital
789 Central Avenue, Dover, NH 03820
Phone: (603) 742-5252
Toll free: 1 (877) 201-7100