Protein energy malnutrition differential diagnosis: Difference between revisions
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Differentiating protein energy malnutrition from other micronutrient deficiency | ==Differentiating protein energy malnutrition from other micronutrient deficiency== | ||
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Revision as of 15:18, 4 August 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Omodamola Aje B.Sc, M.D. [2]
Overview
As protein energy malnutrition manifests in a variety of clinical forms, differentiation must be established in accordance with the particular subtype. Kwashiorkor must be differentiated from other diseases that cause failure to thrive, wasting, edema, skin and hair changes such as congenital heart diseases and micronutrient deficiency. In contrast, marasmus must be differentiated from other diseases that cause generalised wasting, such as vitamin A , iron, iodine, and zinc deficiencies.
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 |
Differentiating protein energy malnutrition from other micronutrient deficiency
| Kwashiorkor | |||
| Marasmus | |||
| Vitamin A deficiency | |||
| Iron deficiency | |||
| Iodine deficiency | |||
| Congenital heart disease | |||
| Dehydration | |||
| Sepsis | |||
| Shigella and campylobacter | |||
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.