Two unusual cases of kwashiorkor: can protein deficiency explain the mystery?
Two children with unusual features of kwashiorkor are reported. One, an exclusively breastfed 7-month-old girl, had been admitted earlier, treated for pneumonia and discharged 3 weeks before she presented with kwashiorkor. The other was an identical twin who was admitted for kwashiorkor and gastro-enteritis. The twin sister was underweight but relatively well. Both children died. Potent aflatoxins were detected in the organs of these children on post-mortem examination. The occurrence of kwashiorkor in a fully breastfed infant and in an identical twin does not accord with the extant belief that the aetiology of kwashiorkor is wholly nutritional, but suggests a disease probably of multifactorial origin.
Department of Paediatrics and Child Health, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria.
O A
OA
Oyelami
S M
SM
Maxwell
T A
TA
Aladekomo
K A
KA
Adelusola
D000348:Aflatoxins / Q000493:pharmacokinetics; D001942:Breast Feeding; D003937:Diagnosis, Differential; D004200:Diseases in Twins; D005260:Female; D006801:Humans; D007223:Infant; D007732:Kwashiorkor / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D009549:Nigeria; D011488:Protein Deficiency / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D014018:Tissue Distribution; D000096702:Aflatoxin Poisoning
D000348:Aflatoxins