A fifteen month old British girl presented with severe anaemia, anasarca, dermatitis, hepatomegaly, hypo-pigmented hair, hair loss and global developmental delay. Initial examination revealed the patient to be of appropriate weight however her height was severely stunted. Blood tests revealed severe iron deficiency anaemia, Vitamin B12 deficiency, and various other vitamin/mineral deficiencies, low albumin and total protein levels. A dietary history revealed she was mainly breastfed from a strict vegan mother. A diagnosis of Kwashiorkor was made and management was commenced. There was no evidence of other pathology and safeguarding procedures where implemented to support the family.
This case illustrates a classical diagnosis commonly made in developing countries of the World as a result of malnutrition. It is not commonly encountered in the developed world due to a strong vigilant network of support for all children in the community and financial support for people with lower socioeconomic status in countries such as the UK.
Whilst Kwashiorkor’s and other forms of protein-energy malnutrition are commonly encountered in developing countries, clinicians and other healthcare providers training in the West have often not encountered them in clinical practice. This depicts the importance of constant learning and maintaining a broader vision when assessing children.
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