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Kwashiorkor

MedGen UID:
7233
•Concept ID:
C0022806
•
Disease or Syndrome
Synonym: Kwashiorkors
SNOMED CT: Kwashiorkor (58262005); Malignant malnutrition (58262005); Deposed child syndrome (58262005); Fatty liver of Brahmin children (58262005); Protein malnutrition (58262005); Nutritional edema with dyspigmentation of skin AND/OR hair (58262005)
 
Monarch Initiative: MONDO:0006826

Definition

Malnutrition caused by severe protein deficiency. In contrast to marasmus, the total caloric intake is sufficient as the diet may be supported by other nutrients such as carbohydrates. Signs may include peripheral edema and ascites. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVKwashiorkor

Professional guidelines

PubMed

Difference between kwashiorkor and marasmus: Comparative meta-analysis of pathogenic characteristics and implications for treatment.
Pham TP, Alou MT, Golden MH, Million M, Raoult D
Microb Pathog 2021 Jan;150:104702. Epub 2021 Jan 3 doi: 10.1016/j.micpath.2020.104702. PMID: 33359074
Acute Malnutrition in Children: Pathophysiology, Clinical Effects and Treatment.
Dipasquale V, Cucinotta U, Romano C
Nutrients 2020 Aug 12;12(8) doi: 10.3390/nu12082413. PMID: 32806622Free PMC Article
Evolution of nutritional management of acute malnutrition.
Golden MH
Indian Pediatr 2010 Aug;47(8):667-78. doi: 10.1007/s13312-010-0103-5. PMID: 20972284

Recent clinical studies

Etiology

Main nutritional deficiencies.
Kiani AK, Dhuli K, Donato K, Aquilanti B, Velluti V, Matera G, Iaconelli A, Connelly ST, Bellinato F, Gisondi P, Bertelli M
J Prev Med Hyg 2022 Jun;63(2 Suppl 3):E93-E101. Epub 2022 Oct 17 doi: 10.15167/2421-4248/jpmh2022.63.2S3.2752. PMID: 36479498Free PMC Article
The Health Benefits of Egg Protein.
Puglisi MJ, Fernandez ML
Nutrients 2022 Jul 15;14(14) doi: 10.3390/nu14142904. PMID: 35889862Free PMC Article
Severe childhood malnutrition.
Bhutta ZA, Berkley JA, Bandsma RHJ, Kerac M, Trehan I, Briend A
Nat Rev Dis Primers 2017 Sep 21;3:17067. doi: 10.1038/nrdp.2017.67. PMID: 28933421Free PMC Article
Gut microbiota and malnutrition.
Million M, Diallo A, Raoult D
Microb Pathog 2017 May;106:127-138. Epub 2016 Feb 4 doi: 10.1016/j.micpath.2016.02.003. PMID: 26853753
Nutritional disorders in tropical neurology.
Román GC
Handb Clin Neurol 2013;114:381-404. doi: 10.1016/B978-0-444-53490-3.00030-3. PMID: 23829926

Diagnosis

Severe childhood malnutrition.
Bhutta ZA, Berkley JA, Bandsma RHJ, Kerac M, Trehan I, Briend A
Nat Rev Dis Primers 2017 Sep 21;3:17067. doi: 10.1038/nrdp.2017.67. PMID: 28933421Free PMC Article
Kwashiorkor in India. 1955.
Gopalan C, Ramalingaswamy V
Indian J Med Res 2012 Jul;136(1):following p. 108. PMID: 23045746Free PMC Article
Acrodermatitis due to nutritional deficiency.
Gehrig KA, Dinulos JG
Curr Opin Pediatr 2010 Feb;22(1):107-12. doi: 10.1097/MOP.0b013e328335107f. PMID: 19966568
Protein energy malnutrition.
Grover Z, Ee LC
Pediatr Clin North Am 2009 Oct;56(5):1055-68. doi: 10.1016/j.pcl.2009.07.001. PMID: 19931063
Tropical pediatrics.
Fischer PR
Pediatr Rev 1993 Mar;14(3):95-9. doi: 10.1542/pir.14-3-95. PMID: 8516235

Therapy

Gut microbiota and malnutrition.
Million M, Diallo A, Raoult D
Microb Pathog 2017 May;106:127-138. Epub 2016 Feb 4 doi: 10.1016/j.micpath.2016.02.003. PMID: 26853753
Oedema in kwashiorkor is caused by hypoalbuminaemia.
Coulthard MG
Paediatr Int Child Health 2015 May;35(2):83-9. Epub 2014 Sep 16 doi: 10.1179/2046905514Y.0000000154. PMID: 25223408Free PMC Article
Protein energy malnutrition.
Grover Z, Ee LC
Pediatr Clin North Am 2009 Oct;56(5):1055-68. doi: 10.1016/j.pcl.2009.07.001. PMID: 19931063
Oedematous malnutrition.
Golden MH
Br Med Bull 1998;54(2):433-44. doi: 10.1093/oxfordjournals.bmb.a011699. PMID: 9830208
Aflatoxins and kwashiorkor.
Lancet 1984 Nov 17;2(8412):1133-4. PMID: 6150186

Prognosis

Nonalcoholic Fatty Liver Disease and the Gut-Liver Axis: Exploring an Undernutrition Perspective.
Bauer KC, Littlejohn PT, Ayala V, Creus-Cuadros A, Finlay BB
Gastroenterology 2022 Jun;162(7):1858-1875.e2. Epub 2022 Mar 3 doi: 10.1053/j.gastro.2022.01.058. PMID: 35248539
Dermatosis in children with oedematous malnutrition (Kwashiorkor): a review of the literature.
Heilskov S, Rytter MJ, Vestergaard C, Briend A, Babirekere E, Deleuran MS
J Eur Acad Dermatol Venereol 2014 Aug;28(8):995-1001. Epub 2014 Mar 24 doi: 10.1111/jdv.12452. PMID: 24661336
Malnutrition and health in developing countries.
Müller O, Krawinkel M
CMAJ 2005 Aug 2;173(3):279-86. doi: 10.1503/cmaj.050342. PMID: 16076825Free PMC Article
Measles & malnutrition.
Bhaskaram P
Indian J Med Res 1995 Nov;102:195-9. PMID: 8675238
Malnutrition at the cellular level in uremia: a new frontier for research.
Metcoff J
J Am Coll Nutr 1986;5(3):229-41. doi: 10.1080/07315724.1986.10720127. PMID: 3525651

Clinical prediction guides

The Health Benefits of Egg Protein.
Puglisi MJ, Fernandez ML
Nutrients 2022 Jul 15;14(14) doi: 10.3390/nu14142904. PMID: 35889862Free PMC Article
Mechanisms of Kwashiorkor-Associated Immune Suppression: Insights From Human, Mouse, and Pig Studies.
Michael H, Amimo JO, Rajashekara G, Saif LJ, Vlasova AN
Front Immunol 2022;13:826268. Epub 2022 May 2 doi: 10.3389/fimmu.2022.826268. PMID: 35585989Free PMC Article
Nonalcoholic Fatty Liver Disease and the Gut-Liver Axis: Exploring an Undernutrition Perspective.
Bauer KC, Littlejohn PT, Ayala V, Creus-Cuadros A, Finlay BB
Gastroenterology 2022 Jun;162(7):1858-1875.e2. Epub 2022 Mar 3 doi: 10.1053/j.gastro.2022.01.058. PMID: 35248539
Difference between kwashiorkor and marasmus: Comparative meta-analysis of pathogenic characteristics and implications for treatment.
Pham TP, Alou MT, Golden MH, Million M, Raoult D
Microb Pathog 2021 Jan;150:104702. Epub 2021 Jan 3 doi: 10.1016/j.micpath.2020.104702. PMID: 33359074
Cupping-related skin lesions.
Franco G, Calcaterra R, Valenzano M, Padovese V, Fazio R, Morrone A
Skinmed 2012 Sep-Oct;10(5):315-8. PMID: 23163078

Recent systematic reviews

Factors associated with yellow fever vaccine failure: A systematic literature review.
Fantinato FFST, Wachira VK, Porto VBG, Peixoto HM, Duarte EC
Vaccine 2023 Mar 24;41(13):2155-2169. Epub 2023 Feb 24 doi: 10.1016/j.vaccine.2023.02.007. PMID: 36841725
Influence of Malnutrition on the Pharmacokinetics of Drugs Used in the Treatment of Poverty-Related Diseases: A Systematic Review.
Verrest L, Wilthagen EA, Beijnen JH, Huitema ADR, Dorlo TPC
Clin Pharmacokinet 2021 Sep;60(9):1149-1169. Epub 2021 Jun 1 doi: 10.1007/s40262-021-01031-z. PMID: 34060020Free PMC Article
Severe malnutrition or famine exposure in childhood and cardiometabolic non-communicable disease later in life: a systematic review.
Grey K, Gonzales GB, Abera M, Lelijveld N, Thompson D, Berhane M, Abdissa A, Girma T, Kerac M
BMJ Glob Health 2021 Mar;6(3) doi: 10.1136/bmjgh-2020-003161. PMID: 33692144Free PMC Article
A systematic review of pharmacokinetics studies in children with protein-energy malnutrition.
Oshikoya KA, Sammons HM, Choonara I
Eur J Clin Pharmacol 2010 Oct;66(10):1025-35. Epub 2010 Jun 16 doi: 10.1007/s00228-010-0851-0. PMID: 20552179
Supplementary vitamin E, selenium, cysteine and riboflavin for preventing kwashiorkor in preschool children in developing countries.
Odigwe CC, Smedslund G, Ejemot-Nwadiaro RI, Anyanechi CC, Krawinkel MB
Cochrane Database Syst Rev 2010 Apr 14;2010(4):CD008147. doi: 10.1002/14651858.CD008147.pub2. PMID: 20393967Free PMC Article

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