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PROTEIN CALORIE MALNUTRITION

Kwashiork or & Marasmus

KWASHIORK MARASMUS OR

Kwashiorkor
a nutritional disorder

due to insufficient consumption of protein but with sufficient calorie intake. is an acute form of childhood proteinenergy malnutrition characterized by edema, irritability, anorexia, ulcerating dermatoses, and an enlarged liver with

Symptoms
Abdominal swelling distension or bloating Diarrhea Enlarged liver Fatigue Frequent infections Generalized swelling Hair and nail changes, including brittle, reddish hair and

ridged nails that are thin and soft Irritability Muscle wasting Skin changes, including pigment loss, red or purple patches, peeling, cracking, skin sloughing, and the development of sores Slowed growth leading to short stature Weight loss

Causes
diet low in protein Presence of infections, parasites in the GI tract It is most common in children living in areas hit

by drought and famine, but it can be related to dietary changes due to milk allergies in infants, fad diets, poor nutritional education, or a chaotic home life.

Risk factors
Conditions that interfere with protein absorption

such as cystic fibrosis Dietary changes for management of milk allergies in infants and children Diets that are low in protein such as a vegan diet Drought or famine Infections that interfere with protein absorption Limited food supply, as may occur during political unrest Parasites such as intestinal worms Poor education about proper nutrition Prolonged hospitalization or residence in a nursing home

Treatment
Antibiotics to treat infections Gradual increases in dietary calories from

carbohydrates, sugars and fats Gradual increases in dietary protein Intravenous fluids to correct fluid and electrolyte imbalances Lactase to assist in digestion of dairy products Vitamin and mineral supplements to treat deficiencies

Potential complications
Anemia (low red blood cell count) Coma Frequent infections Intellectual disability Physical disability Poor wound healing Shock Short stature Skin pigmentation changes Steatohepatitis (fatty liver)

M a ra sm u s
is a form of severe

protein-energy malnutrition characterized by energy deficiency. consists of the chronic wasting away of fat, muscle, and other tissues in the body. one of the most serious forms of protein-energy malnutrition (PEM) in the world.

Signs & Symptoms


Common: Chronic or persistent diarrhea Dizziness Fatigue Unexplained weight loss

May cause serious condition: Fainting or change in level of consciousness or lethargy Full or partial paralysis of the legs

Risk factors
Chronic hunger Contaminated water supplies Inadequate food supplies Other vitamin deficiencies (vitamin A, E or K) Poor, unbalanced diet lacking in grains, fruits

and vegetables, and protein

Potential complications
Growth problems in children Joint deformity and destruction Loss of strength Loss of vision and blindness Organ failure or dysfunction Unconsciousness and coma

Reducing your risk of Marasmus


Eating a nutritious, well-balance diet Discussing symptoms with your health care

provider Drinking properly sanitized water Following the recommended treatment course for infections

Difference
Marasmus Infancy (<2 y/o)

Severe deprivation or impaired absorption of

CHON, energy, vitamins and minerals Develops slowly; chronic PEM Severe weight loss Severe muscle wasting with fat loss Kwashiorkor Older infants and young children (1-3 y/o) Inadequate CHON intake or more commonly infections

Growth<60% weight for age

No detectable edema No fatty liver Anxiety, apathy

Appetite may be normal or impaired Hair is sparse, thin and dry; easily pulled out

Skin is dry, thin and wrinkled Growth 60-80% weight-for-age Edema Enlarged, fatty liver Apathy, misery, irritability, sadness

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