Protein energy malnutrition differential diagnosis: Difference between revisions
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* Surgical options are considered if medical options fail | * Surgical options are considered if medical options fail | ||
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| style="background: #F5F5F5; padding: 5px; text-align: center;" | ''' | | style="background: #F5F5F5; padding: 5px; text-align: center;" | '''Pediatric nephrotic syndrome''' | ||
| style="background: #DCDCDC; padding: 5px;" | | | style="background: #DCDCDC; padding: 5px;" | | ||
| style="background: #F5F5F5; padding: 5px;" | | * Glomerular lesions such as minimal change nephrotic syndrome | ||
* Secondary nephrotic syndromes | |||
* Genetic abnormalities such as infantile nenphrotic syndromes | |||
* Infections | |||
* Drugs | |||
| style="background: #F5F5F5; padding: 5px;" | <16years | |||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* Nephrotic-range proteinuria | * Nephrotic-range proteinuria | ||
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* Hyperlipidemia, | * Hyperlipidemia, | ||
* Hypoalbuminemia | * Hypoalbuminemia | ||
| style="background: #DCDCDC; padding: 5px;" | | | style="background: #DCDCDC; padding: 5px;" | | ||
* Avoid infections and drugs that may predispose to nephrotic syndrome | |||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* Urinalysis | * Urinalysis | ||
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* Serum albumin | * Serum albumin | ||
* Lipid panel | * Lipid panel | ||
| style="background: #DCDCDC; padding: 5px;" | | | style="background: #DCDCDC; padding: 5px;" | | ||
* Prognosis depends on whether the nephrotic syndrome is steroid responsive or steroid resistant | |||
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* Corticosteroids | * Corticosteroids |
Revision as of 11:30, 14 August 2017
Protein energy malnutrition Microchapters |
Patient Information |
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Differentiating Protein energy malnutrition from other Diseases |
Diagnosis |
Treatment |
Case Studies |
Protein energy malnutrition differential diagnosis On the Web |
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Risk calculators and risk factors for Protein energy malnutrition differential diagnosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Omodamola Aje B.Sc, M.D. [2]
Overview
Protein energy malnutrition must be differentiated from other diseases that cause failure to thrive, edema, wasting recurrent infections, skin and hair changes. It is important to also differentiate kwashiorkor from marasmus as the two diseases belong to the protein energy malnutrition.
Differentiating Protein energy malnutrition from other Diseases
Differentiating kwashiorkor from marasmus[1]
Distinguishing Features | Kwashiorkor | Marasmus |
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Cause | Deficiency of protein in the diet of child | Deficiency of protein as well as energy nutrients (that is carbohydrates and fats) in the diet |
Age | Occurs in children in the age group 1-5 years | Typically occurs in children below the age of 1 year |
Association | More common in villages where there is small gap period between successive pregnancies | More common in towns and cities where breast-feeding in discontinued quite early |
Edema | Presence of edema | Absence of edema |
Muscles | Wasting of muscles | Wasting of muscles is quite evident. The child is reduced to skin and bones |
Skin changes | Dermatitis and Hyperpigmentation noticed | Dry and atrophic skin but no changes in color |
Serum cortisol | Decreased/Normal | Increased |
Fasting blood glucose | Decreased | Decreased |
Growth retardation | Mildly retarded in growth | Severely retarded in growth |
Facial appearance | Moon-like face | Elderly man face |
Abdomen | Protuded | Shrunken |
Vitamin deficiency | Present | Present |
Weight | 60-80% of normal weight for age | <60% of normal weight for age |
Differential diagnosis of childhood malnutrition
Disease | Cause | Age(years) | Presentation | Prevention | Workup | Prognosis | Treatment |
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Kwashiorkor |
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Marasmus |
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Protein losing enteropathy |
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Anasarca |
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1-4 |
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Good prognosis if the underlying cause is identified and treated early |
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HIV wasting syndrome | HIV infection |
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Prognosis is good with the use of HAART |
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Congenital heart disease | |||||||
Chronic pancreatitis |
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Pediatric nephrotic syndrome |
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<16years |
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Portal cirrhosis |
Table adapted from CDC Pinkbook.[2]
References
- ↑ Müller O, Krawinkel M (2005). "Malnutrition and health in developing countries". CMAJ. 173 (3): 279–86. doi:10.1503/cmaj.050342. PMC 1180662. PMID 16076825.
- ↑ "Epidemiology and Prevention of Vaccine-Preventable Diseases".