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Kwashiorkor (pronounced /kwɑːʃiˈɔrkər/) is an acute form of childhood protein-energy malnutrition characterized by edema, irritability, anorexia, ulcerating dermatoses, and an enlarged liver with fatty infiltrates. The presence of edema caused by poor nutrition defines kwashiorkor.[1] Kwashiorkor was thought to be caused by insufficient protein consumption but with sufficient calorie intake, distinguishing it from marasmus. More recently, micronutrient and antioxidant deficiencies have come to be recognized as contributory. Cases in the developed world are rare.[2]

Jamaican pediatrician Dr. Cicely D. Williams introduced the name into the medical community in her 1935 Lancet article.[3] The name is derived from the Ga language of coastal Ghana, translated "the sickness the baby gets when the new baby comes",[4][citation needed] and reflecting the development of the condition in an older child who has been weaned from the breast when a younger sibling comes.[5] Breast milk contains proteins and amino acids vital to a child's growth. In at-risk populations, kwashiorkor may develop after a mother weans her child from breast milk, replacing it with a diet high in carbohydrates, especially starches, but deficient in protein.


Signs and symptoms

The defining sign of kwashiorkor in a malnourished child is pedal edema (swelling of the feet). Other signs include a distended abdomen, an enlarged liver with fatty infiltrates, thinning hair, loss of teeth, skin depigmentation and dermatitis. Children with kwashiorkor often develop irritability and anorexia.[1]

Victims of kwashiorkor fail to produce antibodies following vaccination against diseases, including diphtheria and typhoid.[6] Generally, the disease can be treated by adding food energy and protein to the diet; however, it can have a long-term impact on a child's physical and mental development, and in severe cases may lead to death.

In dry climates, marasmus is the more frequent disease associated with malnutrition. Another malnutrition syndrome includes cachexia, although it is often caused by underlying illnesses. These are important considerations in the treatment of the patients. Kwashiorkor can lead to death. People can recover from the illness by having a gradual build up of nutrients, but they will not grow properly and will probably be quite small.

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