Studies on kwashiorkor and marasmus in Calcutta (1957-74) : II. Pathological, biochemical and metabolic studies
Bhattacharyya, A.K.
Indian Pediatrics 12(11): 1115-1123
1975
ISSN/ISBN: 0019-6061 PMID: 819365 Document Number: 84971
2. Autopsies of children with kwashiorkor and marasmus revealed myocardial degeneration and necrosis, renal tubular degeneration and glomerular changes, adrenal degeneration, necrosis and haemorrhage, pancreatic fibrosis and fatty liver. Liver biopsy in pre-kwashiorkor showed no fatty change. Hypoproteinaemia depended on the clinical types and several associated conditions. Blood cholesterol, initially low, rose in conjunction with serum albumin during uncomplicated recovery. Blood urea N, initially low, increased with recovery. In kwashiorkor diarrhoea caused a rise in serum Na and a fall in K. Fasting hypoglycaemia, depressed gastric acidity and, in kwashiorkor, a low protein content of cerebrospinal fluid before recovery were also observed. N absorption from skimmed milk was good in absence of diarrhoea and ascariasis. N retention was initially high and remained so after a month's feeding in marasmus but decreased considerably in fatty kwashiorkor. Mild steatorrhoea occurred with whole milk feeding but this subsided gradually. Older children tolerated a mixed balanced diet.