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Kwashiorkor

Última revisão: 20 Aug 2025
Última atualização: 17 Dec 2024

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • history of famine or monotonous diet
  • child <5 years of age and living in rural community
  • low weight for height, low height for age, or a low mid-upper arm circumference (MUAC)
  • bilateral pitting edema
Detalhes completos

Outros fatores diagnósticos

  • hair discoloration
  • dermatosis/ulceration
  • apathy and reluctance to feed
  • hypothermia
  • oral candida
  • xerophthalmia
  • pallor
  • poor hydration
  • fever
  • irritability
Detalhes completos

Fatores de risco

  • endemic food insecurity or famine
  • rural communities
  • <5 years of age
  • monotonous diet based on maize or cassava
  • dietary protein deficiency
  • HIV infection
  • tuberculosis (TB) nfection
  • measles infection
  • diarrhea
  • weaning off the breast
  • exposure to free radicals
  • antioxidant deficiency
  • aflatoxin poisoning
  • incomplete immunization
  • poor social or economic conditions
  • cerebral palsy
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • clinical diagnosis
Detalhes completos

Investigações a serem consideradas

  • urine dipstick
  • complete blood count (CBC)
  • serum electrolytes
  • serum protein
  • serum albumin
  • blood glucose
  • chest x-ray (CXR)
  • urine culture
  • blood culture
  • stool culture
  • tuberculosis (TB) skin testing
  • HIV serology/polymerase chain reaction (PCR)
  • malaria screen
  • echocardiography
Detalhes completos

Algoritmo de tratamento

AGUDA

uncomplicated

complicated

Colaboradores

Autores

Mark J. Manary, MD

Helene B. Roberson Professor of Pediatrics

Washington University School of Medicine

St Louis

MO

Declarações

MJM is an author of a number of references cited in this topic.

Indi Trehan, MD, MPH, DTM&H

Associate Professor of Pediatrics

Adjunct Associate Professor of Global Health and Epidemiology

University of Washington

Seattle

WA

Declarações

IT is the co-author of a reference cited in this topic.

Agradecimentos

Dr Mark J. Manary and Dr Indi Trehan would like to gratefully acknowledge Dr James E.G. Bunn, the previous contributor to this topic.

Declarações

JEGB declared that he had no competing interests.

Revisores

Beatrice Amadi, MD, MMed.Paed

Consultant Paediatrician

University Teaching Hospital

Department of Paediatrics and Child Health

Lusaka

Zambia

Declarações

BA declares that she has no competing interests.

Tahmeed Ahmed, MD

Adjunct Professor

Public Health Nutrition

James P. Grant School of Public Health

BRAC University

Dhaka

Bangladesh

Declarações

TA declares that he has no competing interests.

George J. Fuchs III, MD

Professor of Pediatrics and Health Policy and Management

University of Arkansas for Medical Sciences

Little Rock

AR

Declarações

GJF declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

World Health Organization. Management of severe malnutrition: a manual for physicians and other senior health workers. 1999. [internet publication].Texto completo

World Health Organization. Management of the child with a serious infection or severe malnutrition: guidelines for care at the first-referral level in developing countries. 2000. [internet publication].Texto completo

World Health Organization. WHO guideline on the prevention and management of wasting and nutritional oedema (‎acute malnutrition)‎ in infants and children under 5 years. 2023 [internet publication].Texto completo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
  • Kwashiorkor images
  • Diagnósticos diferenciais

    • Marasmus
    • Chronic undernutrition
    • Congestive heart failure
    Mais Diagnósticos diferenciais
  • Diretrizes

    • WHO guideline on the prevention and management of wasting and nutritional oedema (‎acute malnutrition)‎ in infants and children under 5 years
    • WHO child growth standards and the identification of severe acute malnutrition in infants and children
    Mais Diretrizes
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