Kwashiorkor is a type of protein-energy malnutrition that commonly affects children between 1-5 years old in third world countries where diets are high in carbohydrates but lack sufficient protein. It develops when a child is weaned off breast milk and given a protein-deficient diet. Symptoms include stunted growth, edema, hair and skin discoloration, and a protruding belly. Biochemically, it is characterized by low plasma albumin and fatty liver. Treatment focuses on providing the child with a diet rich in proteins to replace what was lost.

1. Nur Amalina Aminudddin Baki 082012100067
Shahirah aliya 63
Kamalia iqma 71
Farzana 75
s_udupa@yahoo.com

2. Objectives
• The student should be able to:
– To understand what is
kwashiorkor
– To know the causes and
occurrence of kwashiorkor
– To be aware of the symptoms,
biochemical manifestation ,
treatment and difference from
marasmus

3. Introduction
• Protein- energy malnutrition
• Disease that child gets when the next baby is
born
• develop after a
mother weans her
child from breast milk,
replacing it with a diet
high in carbohydrates
but lack in protein.

4. Occurrence
• Found in children between 1 to 5
Third world countries
Low level
of
education
famine
Limited
food
supply

5. • # 1 South Africa:820 deaths
• # 2 Mexico:75 deaths
• # 3 Brazil:46 deaths
• # 4 Venezuela:13 deaths
• = 5 Peru:11 deaths
• = 5 Ecuador:11 deaths
• # 7 Colombia:10 deaths
• # 8 United States:8 deaths
• # 9 Egypt:5 deaths
• = 10 Paraguay:3 deaths

6. Causes
Breast milk
contains
proteins
and amino
acids vital
to a child's
growth
Diet of a
weaning of
child
mainly
consist of
carbohydra
tes insufficient
intake of
proteins

7. Clinical Symptoms
• Stunted growth
• Diarrhea
• Edema
• Discoloration of hair and skin
• Anemia
• Protuded belly
• Moonface

9. Biochemical Manisfestations
• Decreased plasma albumin concentration(<2g/dl,
N:3-4.5)
• Diarrhea
– Deficiency of K+
• Fatty liver
• Edema
– Lack of adequate plasma proteins to maintain water
distribution between blood and tissues
• Plasma retinol binding protein is reduced
• Immunological response very low

10. Treatment
• Carbohydrates first, then protein
• Ingest protein rich foods
– 3-4g of protein/kg body weight/day
• Treatment can be monitored:
– using plasma albumin concentration
– disappearance of edema
– gain in body weight

11. Kwashiorkor vs. Marasmus
Clinical parameter Kwashiorkor Marasmus
Age of onset Pre- school (1-5
years old )
Weaned infants
(<1years old)
Main nutritional
cause
Low protein intake Low calorie intake
Body weight 60-80% of normal < 60% of normal
Growth Mild retardation Severe retardation
Abdomen Protruding Shrunken
Facial appearances Moonface Like old man’s face

12. Conclusion
• Occurs to lack of protein
• Most likely occur in third world countries
• Characterized by protruded belly
• Can be treated with rich protein foods

13. Reference
• DM Vasudevan Sreekumari, Kannan
Vaidyanathan, textbook of
biochemistry for medical students, sixth
edition,2011.
• U. Satyanarayana and U.Chakrapani,
Biochemistry,3rd edition,2012
• http://www.umm.edu/ency/article/001604pr
v.htm