American Journal of Clinical Nutrition, Vol 17, 15-26, Copyright © 1965 by The American Society for Clinical Nutrition, Inc.

Kwashiorkor in Egypt

I. Clinical and Biochemical Studies, with Special Reference to Plasma Zinc and Serum Lactic Dehydrogenase

¹ From the United States Naval Medical Research Unit No. 3, Cairo, U.A.R., the Pediatric Department, Faculty of Medicine, Cairo University, the Division of Nutrition, Departments of Medicine and Biochemistry, Vanderbilt University School of Medicine, Nashville, Tennessee, and the Interdepartmental Committee on Nutrition for National Defense, National Institute of Arthritis and Metabolic Diseases, National Institutes of Health, Bethesda, Maryland

The clinical findings in thirty-nine Egyptian infants with protein-calorie malnutrition are described. Plasma zinc levels were found to be low and failed to rise to normal with diet therapy, suggesting the presence of zinc deficiency. An increase in serum lactic dehydrogenase (LDH) was usually observed during the acute phase of the disease. A decline toward normal was associated with protein repletion. Marked increases in serum glutamic oxalacetic and serum glutamic pyruvic transaminases (SGOT and SGPT) were infrequent. Serum alkaline phosphatase activity was depressed on admission and increased to normal and above following treatment. Iron deficiency occurred in more than 50 per cent of the patients. Hypocupremia was commonly found in the acute phase of the disease. Elevated plasma copper levels were seen occasionally, more frequently during the recovery phase. Plasma magnesium was normal in the majority of patients during the acute phase of the disease. Serum calcium levels were usually low on admission but rose to normal following treatment. A decreased serum albumin and an increased gamma globulin fraction were the major acute serum protein abnormalities. Albumin levels rapidly returned to normal with treatment. Gamma globulin levels remained elevated.

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