Disease relevance of Kwashiorkor

• Somatomedin-C level was lowest with combined "kwashiorkor-marasmus" (25 percent of normal) and also reduced with "kwashiorkor" (51 percent) or "marasmus" (57 percent) alone [1].
• Eight out of 13 children with kwashiorkor who had steatorrhea also showed raised plasma serotonin levels in parallel with the high urinary excretion of 5-HIAA [2].
• Diffuse small-intestinal damage in celiac disease or kwashiorkor leads to a proportional decrease of all disaccharidase activities, with the most pronounced being decrease of lactase [3].
• However, antibody to Staphylococcus aureus, a common pathogenic bacteria in the tropics, could be detected in the sera of 28 of 30 control children but in only 7 of 30 kwashiorkor cases, suggesting that there is an impairment to specific antibody production in children with malnutrition [4].
• Gastric emptying of 20 ml/kg body weight of 5% glucose was assessed by the double-sample test meal in 22 malnourished hospitalized children divided into two groups according to the form of malnutrition presented: kwashiorkor (n = 11) or marasmic kwashiorkor (n = 11) [5].

Psychiatry related information on Kwashiorkor

• A prospective 15-year follow-up study of kwashiorkor patients. Part II. Social circumstances, educational attainment and social adjustment [6].

High impact information on Kwashiorkor

• Although glutathione, known to participate in LTC4 synthesis, was subnormal in erythrocytes of all malnourished patients, whole-blood LTC4 synthesis was higher in kwashiorkor patients than in controls (28.1 [5.0] ng/mL; p < 0.05), and close to control values (9.8 [1.5] ng/mL) in marasmic children [7].
• Whole blood LTE4 synthesis was increased in kwashiorkor patients by a factor of 3.5 (p < 0.01) [7].
• LTB4 synthesis, however, was greatly reduced in kwashiorkor patients (11.5 [2.4] vs 46.5 [6.4] ng/mL; p < 0.01) [7].
• Urinary LTE4 excretion was significantly higher in patients with kwashiorkor than in controls (118.8 [SD 28.5] vs 31.1 [19.3] nmol/mol creatinine; p < 0.01) [7].
• The methyl folate trap. A physiological response in man to prevent methyl group deficiency in kwashiorkor (methionine deficiency) and an explanation for folic-acid induced exacerbation of subacute combined degeneration in pernicious anaemia [8].

Chemical compound and disease context of Kwashiorkor

• This decrease in T3 was significantly (P less than 0-001) more pronounced in kwashiorkor of recent onset than in long-term P.C.M., a finding which suggests that impaired thyroxine (T4) monodeiodination in the liver was responsible for the fall in serum-T3 concentration rather than a reduction in the secretion of T3 by the thyroid [9].
• Skin sores in kwashiorkor, pellagra, and vitamin B6 deficiency [10].
• Postheparin serum lipolytic activities (hepatic and extrahepatic), serum free fatty acid, and triglyceride levels were measured in 16 kwashiorkor, 14 marasmic, and 14 control children [11].
• Chloramphenicol binding to normal and kwashiorkor sera [12].
• Serotonin metabolism in children with kwashiorkor [2].

Biological context of Kwashiorkor

• In states of malnutrition, such as kwashiorkor, the protein binding of para-aminosalicylic acid decreases from 15% to essentially zero and in the case of ethionamide and streptomycin binding decreases by 6% and 16% respectively [13].
• Acetanilide pharmacokinetics in kwashiorkor [14].
• Observations on the mechanisms underlying the defective methylation of deoxyuridylate in kwashiorkor [15].
• 1 Single dose intravenous gentamicin kinetics (2.4 mg/kg) were studied in six children with kwashiorkor [16].
• Cefoxitin: intravenous pharmacokinetics and intramuscular bioavailability in kwashiorkor [17].

Anatomical context of Kwashiorkor

• Inability to synthesise the immunoregulator LTB4 may lead to inefficient chemoattraction of phagocytes and an inadequate inflammatory response in kwashiorkor [7].
• We studied the effect of a supplement of biotin (10 mg/d) or a placebo under double-blind conditions on plasma biotin concentrations and lymphocyte propionyl CoA carboxylase (PCC) and pyruvate carboxylase (PC) in 22 children with severe protein-energy malnutrition (PEM) (5 with kwashiorkor, 10 with marasmus, and 7 "sugar babies") [18].
• EP obtained from the leukocytes of patients with predominant protein deprivation syndromes (kwashiorkor) before nutritional support produced an attenuated fever (0.23 degrees C over 4 h) and a relatively unchanged plasma iron concentration (delta Fe = -15 microgram/100 ml over 4 h) in the rabbits [19].
• On the other hand, the glutathione (GSH) content in liver cytosol of the kwashiorkor animals was much higher than that of the controls [20].
• We suggest that oxidant stress in kwashiorkor, by reducing cellular glutathione, may affect cell membrane electrolyte transport [21].

Gene context of Kwashiorkor

• Plasma lecithin-cholesterol acyltransferase activity and plasma lipoprotein composition and concentrations in kwashiorkor [22].
• The erythrocyte glutathione-reducing system, represented by G6PDH and glutathione reductase, showed only slight differences among the four groups of children; the supposition that kwashiorkor occurs predominantly in children with aberrant G6PDH could not be substantiated [23].
• In addition, concentrations of IL-6, sTNFR-p55, and sTNFR-p75 are greater in kwashiorkor patients irrespective of the presence of infection [24].
• CYP1A2 activity, measured by the plasma ratios of paraxanthine: caffeine, was significantly lower in kwashiorkor and malaria [25].
• Plasma RBP is decreased to 1.62 mg plus or minus 0.71/100 ml, or 31.1 percent of normal, in the acute stage of kwashiorkor [26].

Analytical, diagnostic and therapeutic context of Kwashiorkor

• Free catecholamine (epinephrine + norepinephrine) excretions of normal male infants 2.1-3.2, 4.5-10.6, and 12.5-18.5 months of age, respectively, and of infants and children with marasmus or marasmic kwashiorkor were measured on three consecutive days after admission and after partial rehabilitation [27].
• Serum alpha 2 HS-glycoprotein levels were studied, using the single-radial immunodiffusion method, in 39 severely malnourished children (22 kwashiorkor, 17 marasmus) of whom 15 (8 kwashiorkor, 7 marasmus) were infected and 24 (14 kwashiorkor, 10 marasmus) had no signs of infection [28].
• There was a positive correlation among serum leptin levels and IGF-1 and IGF-BP3 levels and also a negative correlation among serum leptin levels and basal GH and cortisol levels in children diagnosed with marasmus or kwashiorkor and the control group [29].
• 1. Serum postheparin lipolytic activities (PHLA), triglyceride and free fatty acid concentrations were determined in children with kwashiorkor before and after treatment and also in normal control children [30].
• CONCLUSIONS: These findings, especially the increased glycine/valine ratio, which is characteristic for kwashiorkor, indicate that abnormal placental perfusion is associated with impaired fetal nutrient supply, in the presence of a normal fetal oxygenation [31].

References