You are on a medical mission in Africa where you take care of numerous children like the ones shown above. Height and weight are nearly normal for age. They all have anorexia, a palpable liver, pitting edema, hair that falls out, and dry atrophic peeling skin.Challenge: What is your diagnosis?
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Marasmic kwashiorkar
Yes! such a sad disease..
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First-Second
Kwashiorkor is characterized by marked muscle atrophy with normal or increased body fat due to inadequate protein intake in the setting of adequate calorie intake. Patients have anasarca, round cheeks (moon-face), pursed mouth, pitting edema, peeling skin, alopecia, hepatomegaly, and distended abdomen. The term kwashiorkor means "First-Second" and refers to the condition in an older child who is weaned from breastfeeding with the birth of a subsequent child.
Sources: UpToDate; Wikipedia.
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