The muscular lesions of Kwashiorkor compared with those of other oedematous conditions and malnutrition in the Congolese infant

Abstract

1. The metabolic disorder of the Congolese infant known as Kwashiorkor gives rise to two types of muscle lesions. The first type affects the muscle fibres themselves, causing a foamy change in the sarcoplasm or a condensation of this sarcoplasm with the appearance between the sarcolemmal sheath and its contents of an empty halo. At the same time a certain number of fibres become eosinophilic and filamentous. Others undergo dissolution and the sarcolemmal sheath is then filled with clumps of sarcoplasm surrounded by cells. The second type of lesion is present in the intermysial spaces and the septa: it consists essentially of an oedema. 2. At a more advanced stage the septa become sclerotic, fine fibrous threads appear between the bundles, commencing at the capillaries, around which one can see cuffs of lymphocytes. 3. Such extensive and severe lesions are seen neither in pulmonary infectious disorders nor in the states of malnutrition of various origins which we have seen in the negro child. Neither are they seen in cases of oedema of various origins from which muscle samples were studied. 4. These lesions, therefore, can be considered as being significant in Kwashiorkor. We have not found, in the literature on deficiency oedema, nor on the nutritional oedema of war, findings comparable to those which we have observed in Kwashiorkor.