Pathology - Protein-Energy Malnutrition (Kwashiorkor)
Kwashiorkor is a type of acute protein-energy malnutrition that can result from sepsis, severe infections, and the hypermetabolic state that follows. This disease is brought on by severe physiological stress, which also raises levels of the insulin counterregulatory stress hormones cortisol, glucagon, and adrenaline, which in turn stimulate proinflammatory cytokines. In order to fuel gluconeogenesis, protein catabolism removes protein from organs and muscles. A crucial finding is the presence of hypoalbuminemia, along with the loss of other serum proteins including transferrin and skin degeneration or inadequate wound healing. Loss of plasma oncotic pressure as a result of hypoalbuminemia is the cause of edema. The cytokine milieu leads to the suppression of cellular immunity (see the low lymphocyte count). Although mortality is still high, aggressive nutritional support is still required. Kwashiorkor is more prevalent in extremely underdeveloped nations when diets lack sufficient amounts of protein. Children under these circumstances will also develop ascites and hepatomegaly, which will cause their abdomen to protrude. You can compare kwashiorkor to marasmus, the traditional type of starvation-induced malnutrition. The treatment for marasmus, a hypometabolic state that causes cachexia, is progressive refeeding.
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