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Protein-Calorie Malnutrition

The primary cause of death in underdeveloped countries is protein-calorie malnutrition (PCM).

Also called protein-energy malnutrition (PEM), this condition is caused by insufficient

nutritional intake to meet the bodys needs. While PCM is less common in the United States, it is

found in the elderly population, lower socioeconomic-status children, and convalescent patients,as well as in individuals with some surgical conditions.

KwashiorkorKwashiorkor is a condition of insufficient protein in the presence of adequate calories. Found

most commonly in children as they wean from nursing mothers, kwashiorkor also is called wet

protein-energy malnutrition. Identifying characteristics include severely thin arms and legs witha distended abdomen.

The following also accompany this condition:

Anemia

Diarrhea

Electrolyte imbalances

Kwashiorkor causes:

Fluid retention (edema)

Dry, peeling skin

Hair discoloration

For the hospitalized patient, kwashiorkor may occur in patients who suffer from:

Severe burns

Trauma Sepsis

Life-threatening illness

MarasmusMarasmus is a condition of insufficient protein in conjunction with insufficient calories and also

is commonly found in children weaning from nursing mothers. It is characterized by extremeweakness, loss of body fat and muscle strength, and a skeletal appearance in the hands and in the

temporal muscle in front of and above each ear. Children with marasmus are small for their age.

Also associated with marasmus:

Loss of appetite

Diarrhea

Skin that is dry and baggy

Sparse hair that is dull brown or reddish yellow

Mental retardation

Behavioral retardation

Low body temperature (hypothermia)

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Slow pulse and breathing rates

Marasmus causes:

Stunted growth

Wasted muscle tissue

Mild, moderate, and severe PCMMild, moderate, and severe PCM classifications are not precisely defined, but patients who lose

10%-20% of their body weight without trying are usually said to have moderate PCM. This

condition also is characterized by a weakened grip and inability to perform high-energytasks.

For many clinical settings, the following are used to diagnose PCM:

Height and weight