Diseases kwashiorkor

Diseases of people come in many flavors. There are infectious diseases (measles, mumps, influenza, AIDS,...), nutritional deficiency diseases (scurvy, beriberi, kwashiorkor,...), degenerative diseases (Alzheimer s disease, osteoporosis,...), cancer (of the lung, breast, prostate, liver,...), and single-gene inherited diseases or molecular diseases. In the last category, an important and instructive example is provided by sickle cell anemia. Let s consider this disease and begin to develop a sense of how we can understand it on the basis of what we now know about proteins. 

In Egyptian children with kwashiorkor whose clinical disease became apparent before 7 months of age there was a regular long-delayed and... 

Nigerian children with both moderate and severe kwashiorkor, although there was a tendency toward higher serum IgA values in some children with the severe forms of the disease (M14) (Fig. 4A-C). 

The nutritional status of an animal may affect the disposition of a foreign compound in vivo as well as the metabolism. Many drugs are protein-bound in the plasma, and alteration of the extent of binding for compounds extensively bound may have important toxicological implications. Thus, the decreased plasma levels of albumin after low-protein diets, such as occur in the human deficiency disease Kwashiorkor, might lead to significantly increased plasma levels of the free drug and therefore the possibility of increased toxicity. 

Kwashiorkor usually occurs in the second or third year in the life of a child. Edema is the principal symptom. The condition arises from a combination of circumstances, but the primary cause appears to be a weaning diet that is both inadequate and indigestible and, notably, is lacking of protein. The principal calories are supplied by carbohydrate. The condition is accelerated by repeated infections of a bacterial, parasitic, or vital nature. Without treatment, the disease is fatal in most cases. 

The gut microbiome is also being investigated for its role in severe malnutrition states such as kwashiorkor (156,157). Indeed, a complex interplay exists between the gut microbiota and host metabolism, and likely has far-ranging implications on normal metabolic homeostasis as well as several disease states, the mechanisms of which we are just beginning to elucidate. 

A number of important and, as yet, unexplained discrepancies are apparent in tissue zinc concentrations in this syndrome. Patients with chronic renal disease, with clinical signs and symptoms of zinc deficiency show consistently elevated red blood cell zinc levels (40-42) whereas plasma zinc concentrations have been reported as either low, normal or elevated (40-44). Patients with Kwashiorkor and symptoms of zinc deficiency have... 

Cachexia is loss of weight, muscle atrophy, fatigue, weakness and significant loss of appetite. It is seen in patients with cancer, acquired immunodeficiency syndrome (AIDS), chronic obstructive pulmonary disease and congestive heart failure. Underlying causes are poorly understood, but there is an involvement of inflammatory cytokines, such as TNF-a, IFN-y, IL-6 and tumour-secreted proteolysis-inducing factor. Related syndromes are kwashiorkor and marasmus, although these are most often symptomatic of severe malnutrition. 

I.6. Various Diseases. Abbassy et al. (Al) observed in 12 cases of malnutrition (including kwashiorkor), toxic dyspepsia, 8 cases of acute nephritis, 8 cases of infective hepatitis, and muscular dystrophy an increased spontaneous excretion of xanthurenic acid, the amount of which was found to depend on the severity of the case. In all these cases, with the exception of acute nephritis and hepatitis, the amount of xanthurenic acid was restored to normal levels after vitamin Be therapy. In 8 children with mental retardation, cerebral palsy, recurrent convulsions, 5 with nephrotic syndrome, and 5 with pellagra the amount of xanthurenic acid spontaneously excreted was found to be within the normal range, indicating that pyridoxine is probably not concerned in these cases. 

A specific wasting away disease caused by protein deficiency in third world countries that lack adequate food supplies is called kwashiorkor. It is a word which describes the condition of an infant who has to be weaned away after a year to make room for the next baby. The weaning food, which is mainly sugar and water or a starchy gruel lacks protein or has a poor quali-... 

Symptoms of kwashiorkor are apathy, muscular wasting, and edema. Both the hair and the skin lose their pigmentation. The skin becomes scaly and there is diarrhea and anemia, and permanent blindness can result from this condition. Marasmus is another condition of a wasting away of the body tissues from the lack of calories as well as protein in the diet. In marasmus the child is fretful rather than apathetic and is skinny rather than swollen with edema. Aside from contrasting symptoms between the two diseases, there may be converging symptoms which would be described as marasmic kwashiorkor. 

There is a wide variation of deficiencies between energy and protein deficient diseases as in the cases described by marasmus and kwashiorkor. The term protein-energy malnutrition (PEM) is used to describe those differences. PEM is the result of poverty as well inadequate information on diet. In some countries there is the mistaken belief that the child should not be given high protein food, which is served to the father, while the child drinks the fluid the meat was cooked in. 

Elevation of serum copper is found in cholestasis, obstructive jaundice, primary biliary cholangitis, malignant tumours, kwashiorkor, exocrine pancreatic insufficiency, during the last trimenon of pregnancy and after administration of oestrogens. A decrease in serum copper is typical of Wilson s disease. In some rare cases, it is caused by familial benign hypocupraemia and nutritional deficiency in neonates. 

Diseases such as hypothyreosis, malabsorption, kwashiorkor and pernicious anaemia also cause ChE to decline. 

Two disorders of protein energy nutrition that are widespread among children in economically depressed areas are kwashiorkor (in Ghana, the disease the first child gets when the second is on the way ) and marasmus (from the Greek to waste away ). 

ALB was one of the first identified biochemical markers of malnutrition and has long been used in population studies. ALB is a relatively insensitive index of early protein malnutrition because there is a large amount normally found in the body (4 to 5 g/kg of body weight), it is highly distributed in the extravascular compartment (60%), and it has a long half-life (18 to 20 days). However, chronic protein deficiency in the setting of adequate nonprotein calorie intake leads to marked hypoalbuminemia because of a net ALB loss from the intravascular and extravascular compartments (kwashiorkor). Serum ALB concentrations also are affected by moderate-to-severe calorie deficiency hepatic, renal, and GI disease and infection, tramna, stress, and burns. In many cases, interpretation of serum ALB concentrations relative to nutrition status is difficult however, a positive correlation between decreased serum ALB concentrations and poor clinical outcome has been demonstrated in a variety of settings. Additionally, serum ALB concentrations of 2.5 g/dL or less can be expected to exacerbate ascites and peripheral, pulmonary, and GI mucosal edema due to decreased colloid oncotic pressure. 

Second, there was, of course, malnutrition. Agriculture provided quantity but not quality. Bones found from this period are stunted and show evidence of rickets. Pellagra, kwashiorkor, marasmus, scurvy, and the other deficiency diseases were probably rampant. 

It has been suggested that ingestion of pyrrolizidihe alkaloids by infants should be considered in the aetiology of kwashiorkor, traditionally regarded as a disease linked to protein deficiency. 

The term kwashiorkor refers to a disease originally seen in African children suffering from a protein deficiency. It is characterized by marked hypoalbuminemia, anemia, edema, pot belly, loss of hair, and other signs of tissue injury. The term marasmus is used for prolonged protein-calorie malnutrition, particularly in young children. 

Intestinal diseases that injure the absorptive cells of the intestinal villi diminish lactase activity along the intestine, producing a condition known as secondary lactase deficiency. Kwashiorkor (protein malnutrition), colitis, gastroenteritis, tropical and... 

Reflect and Apply Kwashiorkor is a protein-deficiency disease that occurs most commonly in small children, who characteristically have thin arms and legs and bloated, distended abdomens due to fluid imbalance. When such children are placed on adequate diets, they tend to lose weight at first. Explain this observation. 

The urinary excretion of glycosaminoglycans by juvenile cases of vitamin A deficiency and of protein-calorie malnutrition (kwashiorkor) is less than normal (M41). The predominant differences are the absence of hyaluronic acid and the presence of chondroitin sulfate of low sulfate content (C12). Treatment of the cases with vitamin A deficiency restored the glycosaminoglycan spectrum to normal. Decreased urinary glycosaminoglycan levels have also been noted in primary hepatoma (K6). It has been suggested that the urinary excretion pattern of individual glycosaminoglycans is pathognomic of certain hereditary bone diseases (T3). 

A negative nitrogen balance represents a state of protein deficiency, in which the body is breaking down tissues faster than they are being replaced. The ingestion of insufhcient amounts of protein, or food with poor protein quality, cau result in serious medical conditions in which an individual s overall health is compromised. The immune system is severely affected the amount of blood plasma decreases, leading to medical conditions such as anemia or edema aud the body becomes vulnerable to infectious diseases and other serious conditions. Protein malnutrition in infants is called kwashiorkor, and it poses a major health problem in developing countries, such as Africa, Central and South America, and certain parts of Asia. An infant with kwashiorkor suffers from poor muscle and tissue development, loss of appetite, mottled skin, patchy hair, diarrhea, edema, and, eventually, death (similar symptoms are preseut in adults with protein deficiency). Treatment or prevention of this condition lies in adequate consumption of protein-rich foods [106]. 

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