The colon in kwashiorkor

The colon in kwashiorkor was investigated by means of rectal biopsy and sigmoidoscopy in 20 children, followed by barium enema in 10 of the children. The colon during the acute phase of the disease showed a surface epithelial atrophy, with infiltration of plasma cells and congestion of small vessels. Viewed under the dissecting microscope, a disorganized vascular pattern was seen in all cases. On recovery from kwashiorkor after 3 to 4 weeks, the abnormal vascular pattern and epithelial atrophy of the colon had returned to normal in most children.

Changes in serum creatine kinase ad other biological measurements assoicate with musculature in children rcovering from kwashiorkor

1. Changes in serum creatine kinase activity, creatinine excretion, mid-upper arm and thigh muscle circumference and the ‘X-ray muscle shadow weight’ of the upper arm and thigh muscles have been compared in children recovering from kwashiorkor.

2. Creatine kinase activity rose as the health of the child improved but was subject to large fluctuations mainly associated with the Occurrence of infections. For this reason it is unlikely to be of value in assessing nutritional status on the basis of changes in musculature.

3. Creatinine excretion also increased with treatment and was more consistent. This measurement should be of much greater value than serum creatine kinase.

4. The anthropometric measurements were relatively insensitive to quite large changes in limb musculature.

5. Assessment of musculature by soft-tissue X-rays of the limbs appeared to be a sensitive method of potential value.

Protein-calorie deficiency and disorders of the endocrine glands

Weanling pigs, dogs and rats were fed diets of different protein value. Some dogs and rats remained on the diets through pregnancy, and their offspring were also fed on the experimental diets. Measurements made during the life of the animals included intravenous glucose tolerance, insulin sensitivity, concentrations of growth hormone and insulin in plasma, as well as urinary corticosteroid excretion. The hypophyses, pancreata, thyroids and adrenals were examined histologically. Congenitally malnourished animals, and animals severely malnourished from weaning, showed marked histological changes, especially in the endocrine portion of the pancreas and in the thyroid. However, even a mild deficiency of protein disturbed the endocrine balance and produced marked aberrations in the control of carbohydrate metabolism, which persisted after apparent rehabilitation on a good diet. The experimental findings are discussed in relation to human deficiency syndromes such as marasmus and kwashiorkor.