• Clinical and Experimental Pediatrics
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• 제51권3호
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• pp.329-334
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• 2008

Kwashiorkor는 단백질 결핍으로 인한 영양실조로 저알부민혈증, 설사, 피부염, 부종을 증상으로 나타낸다. 단백질-열량 결핍은 면역결핍을 초래하고 이는 감염에 대한 감수성을 높임으로써 생명을 위협하는 상태가 될 수 있다. 치료는 조기 영양공급, 감염증 치료가 주이며, 치료 경과 중 확장성 심근증이 나타날 수 있으며 이 경우 예후가 안 좋다. Kwashiorkor는 주로 빈곤한 나라에서 생긴다고 알려져 왔으며, 기술적으로 진보한 나라에서 치명적인 결과까지 낳은 예는 보고된 바가 없었다. 치명적인 kwashiorkor 1례를 경험하였기에 보고하는 바이다. 환아는 가난때문이 아니라 부모의 잘못된 생각으로 2개월 동안 곡물에 태운 곡식가루만 먹었으며, 설사, 전신 부종, 홍반, 저체온증 등을 주소로 입원하였다. 면역 결핍이 있는 상태였으며, 혈액 배양 검사상 Alcaligenes Xylosoxidans가 동정되었다. 단백질 보충식이 및 항생제 치료, 정주용 면역글로불린치료, 미세영양소 보충하였으나 확장성 심근병증, 다발성 장기 부전으로 사망하였다.

• 대한한의학회지
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• 제42권1호
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• pp.129-135
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• 2021

Objectives: The present study reports case of an elderly kwashiorkor patient who was treated with Korean Medicine. Methods: A 68-year-old female patient with weight loss, general weakness, chills, anorexia, and dizziness after over 100 episodes of diarrhea visited the hospital. Blood tests showed hypoalbuminemia and anemia, and ultrasonography revealed fatty liver disease. The patient was diagnosed with kwashiorkor, and her symptom differentiation was Yang deficiency followed by Both Qi-Blood deficiency. Sayeok-Tang, Soshiho-Tang, Insamyangyeong-Tang, and Gongjin-Dan, herbal drugs, were given to the patient during 40 days of hospitalization. Results: After 40 days of hospitalization, her symptoms were reduced, and the blood test results improved. Conclusion: This case presents the therapeutic potential of Korean medicine in the treatment of kwashiorkor.

• Clinical and Experimental Pediatrics
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• 제46권11호
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• pp.1131-1134
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• 2003

저자들은 영아성 경축 환아에서 케톤생성 식이요법 중 단백열량부족증(Kwashiorkor)을 포함한 중증의 탈수, 급성신부전과 흡인성 폐렴을 동반한 영아성 경축 1례를 경험하여 문헌 고찰과 함께 보고하여 케톤생성 식이요법시 참고를 하고자 한다.

• Pediatric Infection and Vaccine
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• 제8권2호
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• pp.222-228
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• 2001

아직도 우리나라에서는 미국과 같은 선진국과 비교해 폐결핵의 유병률이 높은 상태이다. 그리고 높은 폐결핵 발생과 함께 장결핵의 발생도 높을 것으로 예상되나 정확한 통계 및 연구는 미비한 실정이다. 또한, 발생 가능성이 높을 것으로 예상되는 장결핵에 의한 영양실조에 대한 관심도 부족한 실정이다. 저자 등은 결핵 발생이 현격하게 감소되지 않는 한 앞으로도 계속 발생할 수 있는 장결핵에 의한 영양실조의 가능성을 상기하고자 장결핵에 의한 영양실조 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Journal of Nutrition and Health
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• 제37권7호
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• pp.540-549
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• 2004

Infants and children with food related Atopic Dermatitis (AD) need extra dietary efforts to maintain optimal nutrition due to food restriction to prevent allergy reactions. However, nutrition ignorance and food faddism make patients even more confused and practice desirable diet more difficult. The objective of this study was to report the AD patients' malnutrition cases in Korea. We report on 2 cases of severe nutritional deficiency caused by consuming macrobiotic diets which avoid processed foods and most animal foods, i.e. one of vegetarian diet. Case 1, a 12-month-old male child, was admitted with severe marasmus. Because of a history of AD, he was started on mixed grain porridge at 3 months without any breast milk or formula feeding. His caloric intake was 66% and protein intake was 69% of the recommended dietary allowance. Patient's height and weight was under 3th percentile. On admission the patient was unable to crawl or roll over. Case 2, a 9-month-old AD female patient, was diagnosed with kwashiorkor and rickets. She was also started on mixed grain porridge at 100 days due to AD. Her caloric intake has been satisfied recommended dietary allowance until 7 months, however, she conducted sauna bath therapy and reduced both energy and protein intake at 8 months. The amount of protein intake for case 2 was higher than recommended dietary allowance, but, sauna therapy and severe AD with intakes of low guality protein may increase patient's protein requirement resulting in kwashiorkor. Case 2 patient's height and weight was on 3th percentile. Both cases showed low intake of calcium, iron, zinc, vitamin A, vitamin E and especially very low intake of vitamin B$_{12}$ and vitamin D. Allergy tests for certain foods had not done prior to admission for both cases. They followed the dietary advise operated by macrobiotic diet internet site. In conclusion, AD infants' parents and caregivers should contact a pediatrician trained as a specialist in allergy for accurate diagnosis. For infant patients, breast or formula feeding including hypoallergenic formula should be continued until their one year of age. When certain foods need to be restricted or to follow special diets such as vegetarian diet, consultation with pediatrician and dietitian is needed.d.

• Archives of Pharmacal Research
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• 제27권7호
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• pp.693-712
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• 2004

The rats with protein-calorie malnutrition (PCM, 5％ casein diet for a period of 4-week) were reported to exhibit 60 and 80％ suppression in the hepatic microsomal cytochrome P450 (CYP) 1 A2 and CYP2C11 levels, respectively, and 40-50％ decreases in CYP2E1 and CYP3A 1/2 levels compared to control (23％ casein diet for a period of 4-week) based on Western blot analysis. In addition, Northern blot analysis showed that CYP1 A2, CYP2E1, CYP2C11, and CYP3A1/2 mRNAs decreased in the state of PCM as well. Hence, pharmacokinetic changes of the drugs in rats with PCM [especially the area under the plasma concentration-time curve from time zero to time infinity (AUC) changes of metabolite(s)] reported from literatures were tried to explain in terms of CYP isozyme changes in the rats. Otherwise, the time-averaged nonrenal clearance ($CL_{NR}$) of parent drug was compared. Pharmacokinetic changes of the drugs in other types of malnutritional state, such as kwashiorkor and marasmus, in both human and animal models were also compared. The drugs reviewed are as follows： diuretics, antibiotics, anticancer agents, antiepileptics, antiarrythmics, analgesics, xanthines, antimalarials, and miscellaneous.

• 대한지역사회영양학회:학술대회논문집
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• 대한지역사회영양학회 2004년도 춘계학술대회
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• pp.415-416
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• 2004

Infants and children with food related Atopic dermatitis (AD) need extra dietary efforts to maintain optimal nutrition due to food restriction to prevent allergy reactions. However, nutrition ignorance and food faddism make patients even more confused and practice desirable diet more difficult. The objective of this study was to report the AD patients' malnutrition cases in Korea.(omitted)

• Journal of Nutrition and Health
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• 제33권2호
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• pp.179-185
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• 2000

This study investigated the nutritional status of 33 hemodialysis patients. Their weight, height, triceps and mid-arm circumference were measured and their dietary intake and blood profiles evaluated. The subjects were 57.1$\pm$11.9 years old. The energy intakes of men and women were 61% and 68% of RDA, respectively. The men and women's intake of protein was 0.93g/IBWkg/d and 0.99g/IBWkg/d, respectively. According to the distribution of BMI, 22.2% of the men and 73.3% of the women were underweight. A total of 5.6% of the men were overweight, versus none of the women. The serum albumin levels of the men and women were 3.56 and 3.52g/dl, respectively. The serum cholesterol levels of the men and women were 134.1 and 148.5mg/dl, respectively. The subjects were divided into three groups according to the level of albumin, and their intakes of nutrients were compared with one another. The group with high levels of albumin did not show higher energy and protein intake than the other groups but the serum total protein level was significantly higher. When the nutritional status of the patients was evaluated by weight and serum albumin level, 6.0% of them showed kwashiorkor-type malnutrition and 75.8% of them showed mild malnutrition.

• 대한지역사회영양학회지
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• 제8권4호
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• pp.574-583
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• 2003

The purpose of this study was to investigate the anthropometry, biochemical parameters and electrolytes concentrations of the Total Parenteral Nutrition (TPN) patients according to their nutritional status at the time of admission. Thirty-three patients in the Intensive Care Unit at S University Hospital were the subjects of this study. Their nutritional status was classified as At-risk I (Mild PCM, n = 13), At - risk II (Moderate PCM, n = 9) and At-risk III (Marasmus + kwashiorkor + severe PCM, n = 11) . Anthropometeric, biochemical and dietary assessments were performed. The Patients intake of calories (75.02%) and protein (53.15%) was insufficient compare with Korean RDA requirements. The body weight and the Body Mass Index (BMI) in the At-risk III group were significantly lower than in the other groups. The percentage of body weight loss and change of body weight (kg) were significantly higher than in the other groups. The subjects were malnourished as indicated by nutritional related parameters such as serum total protein, albumin, total lymphocyte count (TLC), hemoglobin and hematocrit. Serum total protein, albumin and TLC levels were lower at the time of admission before TPN administration. But after TPN administration, they increased. The electrolyte concentrations did not show any differences following TPN administration. The nutritional status of the patients could be affect by the duration of TPN administration and the number of days of the patients hospitalization. The patients who require nutritional support need the continuous follow-up care and monitoring by a nutritional support team. (Korean J Community Nutrition 8(4) : 574-583, 2003)

• Journal of Yeungnam Medical Science
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• 제22권2호
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• pp.253-258
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• 2005

Generalized edema and hypoalbuminemia are relatively common presenting manifestations in many clinical situations. The differential diagnosis of hypoalbuminemia include: Kwashiorkor, synthetic dysfunction of the liver, and excessive protein loss as in nephrotic syndrome. In systemic lupus erythematosus (SLE), hypoalbuminemia and generalized edema are most commonly due to protein loss associated with lupus nephritis; gastrointestinal involvement is uncommon, and therefore protein loss through the gastrointestinal tract is quite rare. We report a case of a protein losing enteropathy (PLE) associated with SLE. The patient was referred to our hospital for generalized edema, arthralgia and facial rash. After clinical evaluation, the patient met the criteria for the SLE diagnosis; hypoalbuminemia with general edema was consistent with a protein losing enteropathy. After two weeks of therapy with parenteral high dose glucocorticoid, the patients was improved in laboratory findings as well as clinical symptoms.