Anaemias of marasmus and kwashiorkor in Kenya

A comparison of maternal and foetal folacin and cobalamin activities at parturition in relation to Plasmodium falciparum infection

Folacin deficiency in malaria endemic areas is not reported other than in severely malnourished children. This is surprising in view of the high incidence in these areas of malaria in pregnancy, with its complications of prematurity and low birth weight, all of which can predispose to folacin deficiency. This paper reports results of folacin and cobalamin activities of blood samples collected from women at parturition and their newborns in a holoendemic area in West Kenya. Evidence is given that Plasmodium falciparum infection has little influence on cord plasma or red cell folacin activities. Mean values for folacin and cobalamin are not low when compared with reported values from neonates from temperate climates.

Gelatinous transformation of bone marrow in prolonged self-induced starvation

In bone marrow from 3 patients with prolonged, severe self-induced starvation, fat atrophy, hypoplasia of haemopoietic cells and characteristic gelatinous transformation of marrow were noted. The gelatinous substance appeared amorphous and stained pink with the Wright-Giemsa stains. Histochemical and ultrasturctural studies indicated that it consisted of acid mucopolysaccharides and was extracellular in nature. Similar marrow abnormalities were produced in rabbits by limitating their food intake for 4 months. These marrow abnormalities in the experimental animals could be reverted to normal by restoring their nutritional status. It is proposed that the gelatinous transformation of marrow is caused by excessive production of mucopolysacchrides of the ground substance to compensate for the mobilization of marrow fat which occurs to meet the energy requirement. It is further postulated that excessive production of acid mucopolysaccharides may provide a microenvironment unsuitable for haemopoietic proliferation. The relevance of these findings to other conditions associated with marrow aplasia, is discussed.

The jejunal mucosa in kwashiorkor

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