PROTEIN ENERGY MALNUTRITION (PEM)- Kwashiorkor and Marasmus
PEM Protein-energy undernutrition (PEU) Kwashiorkor Marasmus causes Cases treatment Case 1 A 4 year old girl brought to the hospital with a complaint of failure to thrive and generalized swelling all over the body. She had a history of repeated respiratory infections and intermittent diarrhea. She belongs to a poor family and resides in a slum area. Diagnosis- Kwashiorkor (Protein-energy malnutrition) Cause – Low protein in the diet Treatment – high protein diet Case 2 A 3 year old child from a poor illiterate family reported with edema, discoloration of hair and skin, anemia, diarrhea. His serum albumin and K+ were low. i) Give the diagnosis and etiology ii) What is the cause of edema Albumin level decreases in kwashiorkor hence oncotic pressure decreases. The oncotic pressure is in direct opposition with the hydrostatic pressure and tends to draw the water back into capillaries by osmosis. Hence in albumin deficiency, fluid accumulates in the tissues and causes edema. iii) Suggest line of treatment and preventive measures Supportive therapy-ORS for diarrhea High protein diet- Eggs, meat, fish, pulses, mushrooms etc Vitamin and mineral supplementation Vaccination for the age

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