Protein energy malnutrition (patient information): Difference between revisions
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{{CMG}};{{AE}}{{DAMI}} | {{CMG}};{{AE}}{{DAMI}} | ||
==Overview== | ==Overview== | ||
Kwashiorkor is a form of [[malnutrition]] that occurs when there is not enough protein in the diet. | |||
==Causes== | ==Causes== | ||
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*Limited food supply | *Limited food supply | ||
*Low levels of education (when people do not understand how to eat a proper diet) | *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. | 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 United States. There are only isolated cases. However, one government estimate suggests that as many as 50% of elderly people in nursing homes in the United States do not get enough protein in their diet. | |||
When kwashiorkor does occur in the United States, it is most often a sign of child abuse and severe neglect. | |||
==Symptoms== | ==Symptoms== | ||
Symptoms include: | Symptoms include: | ||
* | *Changes in skin [[pigmentation]] | ||
*[[Muscle mass|Loss of muscle mass]] | *[[Muscle mass|Loss of muscle mass]] | ||
*[[Diarrhea]] | *[[Diarrhea]] | ||
*Failure to gain weight and grow | *Failure to gain weight and grow | ||
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*Increased and more severe infections due to damaged [[Immune systems|immune system]] | *Increased and more severe infections due to damaged [[Immune systems|immune system]] | ||
*[[Irritability]] | *[[Irritability]] | ||
*Large belly that sticks out (protrudes) | |||
*[[Lethargy]] or [[apathy]] | *[[Lethargy]] or [[apathy]] | ||
*[[Rash]] ([[dermatitis]]) | *[[Rash]] ([[dermatitis]]) | ||
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==Diagnosis== | ==Diagnosis== | ||
The physical exam may show an enlarged liver (hepatomegaly) and general swelling. Tests may include: | The physical exam may show an enlarged liver (hepatomegaly) and general swelling. | ||
Tests may include: | |||
*[[Arterial blood gas]] | *[[Arterial blood gas]] | ||
*[[BUN]] | *[[BUN]] | ||
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==Treatment== | ==Treatment== | ||
Getting more [[calories]] and [[protein]] will correct | 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 potential for [[height]] and [[growth]]. | ||
Treatment depends on the severity of the condition. People who are in [[shock]] need treatment right away to restore blood volume and maintain | Treatment depends on the severity of the condition. People who are in [[shock]] need treatment right away 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 | 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. | ||
Many malnourished children will develop intolerance to milk sugar (lactose intolerance). They will need to be given supplements with the | 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. | ||
==Outlook (Prognosis)== | ==Outlook (Prognosis)== | ||
Getting treatment early generally leads to good results. Treating | 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. | ||
Possible Complications | |||
==Complications== | ==Complications== | ||
Complications may include: | Complications may include: | ||
* | *Coma | ||
*Permanent | *Permanent mental and physical disability | ||
* | *Shock | ||
==When to Contact a Medical Professional== | ==When to Contact a Medical Professional== | ||
Call your health care provider if your child has symptoms of | Call your health care provider if your child has symptoms of kwashiorkor. | ||
==Prevention== | ==Prevention== | ||
To prevent | To prevent kwashiorkor, make sure the diet has enough carbohydrates, fat (at least 10% of total calories), and protein (12% of total calories). | ||
==Alternative Names== | ==Alternative Names== | ||
Protein malnutrition; Protein-calorie malnutrition; Malignant malnutrition | Protein malnutrition; Protein-calorie malnutrition; Malignant malnutrition | ||
Latest revision as of 16:27, 20 September 2017
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Protein energy malnutrition |
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Protein energy malnutrition On the Web |
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Risk calculators and risk factors for Protein energy malnutrition |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Omodamola Aje B.Sc, M.D. [2]
Overview
Kwashiorkor is a form of malnutrition that occurs when there is not enough protein in the diet.
Causes
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 United States. There are only isolated cases. However, one government estimate suggests that as many as 50% of elderly people in nursing homes in the United States do not get enough protein in their diet.
When kwashiorkor does occur in the United States, it is most often a sign of child abuse and severe neglect.
Symptoms
Symptoms include:
- Changes in skin pigmentation
- Loss of 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
- Rash (dermatitis)
- Shock (late finding)
- Swelling (edema)
Diagnosis
The physical exam may show an enlarged liver (hepatomegaly) and general swelling. Tests may include:
- Arterial blood gas
- BUN
- Complete blood count (CBC)
- Creatinine clearance
- Serum creatinine
- Serum potassium
- Total protein levels
- Urinalysis
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 potential for height and growth.
Treatment depends on the severity of the condition. People who are in shock need treatment right away 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.
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.
Outlook (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. Possible Complications
Complications
Complications may include:
- Coma
- Permanent mental and physical disability
- Shock
When to Contact a Medical Professional
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% of total calories), and protein (12% of total calories).
Alternative Names
Protein malnutrition; Protein-calorie malnutrition; Malignant malnutrition