Kwashiorkor

Edematous malnutrition affecting children, characterized by bilateral pitting edema, in the absence of another medical cause of edema.

Other clinical signs include a poor appetite, ulcerating dermatosis, and apathy.

Etiology remains ill defined, but is not entirely because of a deficiency of protein in the diet, as commonly suggested. It is typically associated with a maize-based diet, recent weaning, measles, or diarrheal illness.

Most often seen in sub-Saharan Africa and is rare in the developed world unless associated with underlying disease such as HIV.

Uncomplicated cases are managed with ready-to-use therapeutic food (RUTF) at home. Complicated cases are treated at an inpatient facility.

Complications include infections, hypoglycemia, hypothermia, xerophthalmia, electrolyte disturbance, and cardiac failure.

Initial stabilization is with fluid and oral calorie intake restricted to maintenance requirements. Antibiotic therapy should be routinely given to all cases.

Kwashiorkor, or edematous malnutrition, is defined as the presence of bilateral pitting edema, in the absence of another medical cause of edema, generally occurring while receiving a monotonous cereal-based diet. Marasmic kwashiorkor is the presence of severe wasting in addition to edema. Kwashiorkor typically occurs in children around the time of weaning and up to 4 years of age, although it may present later, particularly when associated with tuberculosis (TB) or HIV. Edema of kwashiorkor is evident in the soft tissues of the extremities, rather than as ascites.