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Kwashiorkor revisited: the pathogenesis of oedema in kwashiorkor and its significance.
Trans R Soc Trop Med Hyg 1984; 78(4):436-41TR

Abstract

Cicely Williams, in her original description of kwashiorkor, implied that deficiency of protein in the baby's food could be a main cause of the syndrome. The hallmark of kwashiorkor is oedema. According to the 'classical' theory, an inadequate intake of protein leads to a low plasma albumin concentration, which in turn causes oedema. This theory has been contested from several points of view: that hypoalbuminaemia is not the major factor determining the presence of oedema, and that there is no real evidence of dietary protein deficiency. The resolution of this question is of some importance from the point of view of public health diagnosis and prevention. A crucial point in the argument is the pathogenesis of oedema, which is discussed in some detail. Although it is clearly multifactorial, with electrolyte disturbances--potassium deficiency and sodium retention--playing an important role, it is contended that the classical theory is essentially correct. On the dietary side, recent experimental work supports the earlier view that the development of oedema depends on a relative deficiency of protein with a relative excess of energy. Comparisons of intakes with requirements are unconvincing in view of uncertainty about the validity of the estimates of children's needs for protein.

Authors

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Pub Type(s)

Journal Article

Language

eng

PubMed ID

6485050

Citation

Waterlow, J C.. "Kwashiorkor Revisited: the Pathogenesis of Oedema in Kwashiorkor and Its Significance." Transactions of the Royal Society of Tropical Medicine and Hygiene, vol. 78, no. 4, 1984, pp. 436-41.
Waterlow JC. Kwashiorkor revisited: the pathogenesis of oedema in kwashiorkor and its significance. Trans R Soc Trop Med Hyg. 1984;78(4):436-41.
Waterlow, J. C. (1984). Kwashiorkor revisited: the pathogenesis of oedema in kwashiorkor and its significance. Transactions of the Royal Society of Tropical Medicine and Hygiene, 78(4), pp. 436-41.
Waterlow JC. Kwashiorkor Revisited: the Pathogenesis of Oedema in Kwashiorkor and Its Significance. Trans R Soc Trop Med Hyg. 1984;78(4):436-41. PubMed PMID: 6485050.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Kwashiorkor revisited: the pathogenesis of oedema in kwashiorkor and its significance. A1 - Waterlow,J C, PY - 1984/1/1/pubmed PY - 1984/1/1/medline PY - 1984/1/1/entrez SP - 436 EP - 41 JF - Transactions of the Royal Society of Tropical Medicine and Hygiene JO - Trans. R. Soc. Trop. Med. Hyg. VL - 78 IS - 4 N2 - Cicely Williams, in her original description of kwashiorkor, implied that deficiency of protein in the baby's food could be a main cause of the syndrome. The hallmark of kwashiorkor is oedema. According to the 'classical' theory, an inadequate intake of protein leads to a low plasma albumin concentration, which in turn causes oedema. This theory has been contested from several points of view: that hypoalbuminaemia is not the major factor determining the presence of oedema, and that there is no real evidence of dietary protein deficiency. The resolution of this question is of some importance from the point of view of public health diagnosis and prevention. A crucial point in the argument is the pathogenesis of oedema, which is discussed in some detail. Although it is clearly multifactorial, with electrolyte disturbances--potassium deficiency and sodium retention--playing an important role, it is contended that the classical theory is essentially correct. On the dietary side, recent experimental work supports the earlier view that the development of oedema depends on a relative deficiency of protein with a relative excess of energy. Comparisons of intakes with requirements are unconvincing in view of uncertainty about the validity of the estimates of children's needs for protein. SN - 0035-9203 UR - https://www.unboundmedicine.com/medline/citation/6485050/Kwashiorkor_revisited:_the_pathogenesis_of_oedema_in_kwashiorkor_and_its_significance_ L2 - https://academic.oup.com/trstmh/article-lookup/doi/10.1016/0035-9203(84)90053-1 DB - PRIME DP - Unbound Medicine ER -