Abstract
Severe malnutrition in childhood is considered a global burden. Micronutrient and protein-calorie deficiencies encompass a clinical spectrum from a minor nutritional problem to a myriad of life-threatening disorders. We present a series of three clinical cases of severe acute malnutrition with common complications and specific treatment. A 14-month-old boy (Case 1), a 16-month-old girl (Case 2) and a 19-month-old girl (Case 3) were admitted to our hospital for generalized edema. Physical examination revealed severe stunting and wasting (Z-score<-3, according to WHO), with pallor, anasarca and severe neurodevelopment defects. Laboratory investigations showed severe anemia, hypoglycemia, hypoalbuminemia, altered coagulation, elevated liver enzymes, cholestasis and metabolic acidosis. Serology tests resulted negative for infections (human immunodeficiency virus, hepatitis B and hepatitis C viruses). After excluding other conditions, findings regarding physical and laboratory evaluations were attributed to severe malnutrition. The treatment was started with a high-calorie and high-protein diet, intravenous albumin, antibiotics, vitamin K, blood transfusion and correction of micronutrient deficiencies, with favorable outcome. Even though the prevalence of malnutrition has reduced in the last years, the low socioeconomic status continues to be a significant risk factor in the developing countries.
Published Version
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