Kalphic dystrophy

Introduction to malignant malnutrition Malignant malnutrition is a syndrome caused by a severe deficiency of protein in food. It is common in children, especially in Africa and Asia. People eat starchy substances to get enough or excess calories, and serious protein deficiency. Leading to physiological and mental retardation, muscle atrophy, fatty liver, moon face and edema, intestinal surgery can induce similar secondary protein deficiency. basic knowledge The proportion of illness: 0.001% Susceptible people: no special people Mode of infection: non-infectious Complications: edema, fatty liver

Causes of malignant malnutrition

(1) Causes of the disease

In developing countries, protein malnutrition is the most important cause of this disease. In these areas, the daily staple food is mostly corn, rice or beans. Other factors associated with insufficient protein intake are also associated with Kwashiorkor (required aromatic amino acids and vitamins). lack of).

(two) pathogenesis

Due to the lack of protein, the ultrastructural changes of the skin keratinocytes and the number of desmosomes are reduced, and the liver exhibits pathological changes of fatty liver.

Prevention of malignant malnutrition

Pay attention to the dietary nutrition of children, pay attention to correct the protein, electrolytes and vitamins of the eclipse.

Complications of malignant malnutrition Complications, edema, fatty liver

Liver (fatty liver) and edema due to hypoproteinemia and hypoglycemia.

1. Water and electrolyte disorders: patients with this disease often have hypoproteinemia, increased total fluid volume, making the extracellular fluid hypotonic, when vomiting, diarrhea, easy to cause hypotonic dehydration and serious dielectric disturbance, resulting in Hypokalemia, hyponatremia, hypocalcemia, and hypomagnesemia cause symptoms.

2. Often accompanied by other nutrient deficiencies, especially vitamin A deficiency, corneal dryness and softening, and even perforation. Also often accompanied by vitamin B deficiency caused by angular keratitis. Due to the slow growth and development, it is rare to see snoring, often accompanied by nutritional anemia.

3. Due to low systemic immune function, it is easy to develop a variety of acute and chronic infections and infectious diseases, especially intestinal and respiratory infections, easy to spread measles, tuberculosis and other infectious diseases and parasitic diseases, digestive tract or systemic fungal infections are not Rare. Once an infection occurs, it often does not heal. Gram-negative bacilli enteritis, sepsis or urinary tract infections are often difficult to cure.

Symptoms of malignant malnutrition common symptoms zoster swell swelling nasal mucosa swelling foot back swelling small stomach syndrome nitrogen negative balance

Children from 6 months to 5 years old are affected by this disease. Not all cases have skin symptoms. Once skin symptoms appear, they are characteristic. Black people are susceptible to this disease. The typical clinical features are as follows: skin discoloration is a Early symptoms may be caused by a lack of phenylalanine in the food, and there may be oral perioral, especially in the lower leg. The skin may also show edema swelling. In addition, post-inflammatory hyperpigmentation may also occur. Has important diagnostic implications.

1. Inflammatory skin disease The skin changes are more common in the diaper area of children, and the hips, knees, elbows and torso are common. First, erythema appears, and then becomes red or brownish red, and scarring occurs. Initially similar to dry eczema, the skin lesions are irregular, the edges are clear, and often diffusely distributed.

2. Hair hair is dry, dull, light reddish brown, and rare, easy to break.

3. Mucosal dry lipitis, female vaginal vaginitis is very common.

4. Medical symptoms due to hypoproteinemia and hypoglycemia caused by hepatic (fatty liver) and edema, mild cases, after appropriate food and protein intake, symptoms can be resolved, severe or recurrent cases relative mortality Higher.

Examination of malignant malnutrition

1. The decrease in serum albumin serum albumin concentration is the most important change, but its half-life is longer (19-21 days), so it is not sensitive enough. Retinol-binding protein (half-life 10 hours), prealbumin (half-life 1.9 days), thyroid-binding prealbumin (half-life 2 days) and transferrin (half-life 3 days) have early diagnosis of plasma proteins with shorter metabolic cycles value. Insulin-like growth factor 1 (IGF1) is not only sensitive but also less affected by other factors, and is a good indicator for diagnosing protein malnutrition.

2. The concentration of serum amino acid taurine and essential amino acids is reduced, while non-essential amino acids are not changed much.

3. Other serum amylase, lipase, cholinesterase, transaminase, alkaline phosphatase and other activities decreased, after treatment can return to normal; cholesterol, various electrolytes and trace elements decreased; growth hormone levels increased.

Diagnosis and identification of malignant malnutrition

According to the medical history, the incidence of infants and young children and typical clinical symptoms, it is not difficult to make a diagnosis. It needs to be distinguished from the accompanying Lager. This disease is common in adults, with sun exposure and no damage to hair and nails.

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