The term kwashiorkor, meaning "the disease of the displaced child" in the language of Ga, was first defined in the 1930s in Ghana. Kwashiorkor is one of the more severe forms of protein malnutrition and is caused by inadequate protein intake. It is, therefore, a macronutrient deficiency.
Kwashiorkor is largely a problem in the developing world, although it can be found in geriatric and hospitalized patients in Western nations. Generally, kwashiorkor occurs when drought, famine, or societal unrest leads to an inadequate food supply. Protein-depleted diets in such areas are mostly based on starches and vegetables, with little meat and animal products. A lack of maternal understanding regarding balanced diets further contributes to the problem. Finally, infections and other disease states negatively impact nutrient intake, digestion, and absorption.
Children are most at risk due to their increased dietary needs. Inadequate caloric and protein intake manifests itself with certain physical characteristics. Symptoms may include any of the following: failure to gain weight, stunted linear growth, generalized edema, protuberant (swollen) abdomen, diarrhea, skin desquamation (peeling) and vitiligo (white spots on the skin), reddish pigmentation of hair, and decreased muscle mass. Mental changes include lethargy, apathy, and irritability. Physiologic changes include a fatty liver, renal failure, and anemia. During the final stages of kwashiorkor, patients can experience, shock, coma, and, finally, death.
Treatment of kwashiorkor begins with rehydration. Subsequent increase in food intake must proceed slowly, beginning with carbohydrates followed by protein supplementation. If treatment is initiated early, there can be a regression of symptoms, though full height and weight potential will likely never be reached.