Protein energy malnutrition differential diagnosis: Difference between revisions
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| style="background: #F5F5F5; padding: 5px; text-align: center;" | Portal cirrhosis | | style="background: #F5F5F5; padding: 5px; text-align: center;" | Portal cirrhosis | ||
| style="background: #DCDCDC; padding: 5px;" | | | style="background: #DCDCDC; padding: 5px;" | | ||
* Hepatitis C (26%) | |||
| style="background: #F5F5F5; padding: 5px;" | | * Alcoholic liver disease (21%) | ||
* Hepatitis C plus alcoholic liver disease (15%) | |||
* Cryptogenic causes (18%) - Many cases actually are due to NAFLD | |||
* Hepatitis B - May be coincident with hepatitis D (15%) | |||
* Miscellaneous (5%) | |||
| style="background: #F5F5F5; padding: 5px;" | 5th - 6th decade of life | |||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
| style="background: #DCDCDC; padding: 5px;" | | * Hepatomegaly | ||
| style="background: #F5F5F5; padding: 5px;" | | * Abdominal pain | ||
* Ascites | |||
* Abdominal distension | |||
* Bulging flanks | |||
* Shifting dullness | |||
* Puddle sign | |||
| style="background: #DCDCDC; padding: 5px;" | | |||
* Avoid alcohol | |||
* Treatment and vaccination against hepatitis | |||
* Good diet and exercise | |||
| style="background: #F5F5F5; padding: 5px;" | | |||
* CBC | |||
* Albumin | |||
* Culture | |||
* Total protein | |||
* Serum ascites albumin gradient | |||
* Ammonia level | |||
* | |||
| style="background: #DCDCDC; padding: 5px;" | Prognosis is poor | |||
| style="background: #F5F5F5; padding: 5px;" | | |||
* Prednisone and azathioprine - For autoimmune hepatitis | |||
* Interferon and other antiviral agents - For hepatitis B and C | |||
* Phlebotomy - For hemochromatosis | |||
* Ursodeoxycholic acid - For primary biliary cirrhosis | |||
* Trientine and zinc - For Wilson disease | |||
* Liver transplantation | |||
|} | |} | ||
<small>Table adapted from CDC Pinkbook.<ref name="CDC90">{{cite web | title = Epidemiology and Prevention of Vaccine-Preventable Diseases | url = http://www.cdc.gov/vaccines/pubs/pinkbook/table-of-contents.html }}</ref></small> | <small>Table adapted from CDC Pinkbook.<ref name="CDC90">{{cite web | title = Epidemiology and Prevention of Vaccine-Preventable Diseases | url = http://www.cdc.gov/vaccines/pubs/pinkbook/table-of-contents.html }}</ref></small> |
Revision as of 11:44, 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 |
American Roentgen Ray Society Images of Protein energy malnutrition differential diagnosis |
Protein energy malnutrition differential diagnosis in the news |
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 |
---|---|---|
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 |
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5th - 6th decade of life |
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Prognosis is poor |
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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".