39.4 Case Studies of Protein Energy Malnutrition..............
Q.1. A 3-year-old child was observed to have mild generalized edema, intermit-
tent diarrhea, rough skin, and coarse hair and weakness. Laboratory investi-
gation data showed:
Hemoglobin–8 mg%
Total proteins (serum)–4.9 g/dl
Albumin (serum)–1.7 g/dl
Urine constituents–normal
What is the probable diagnosis?Ans: Generalized edema, intermittent diarrhea, rough skin, and coarse hair indi-
cate protein-deficient diet intake. This appears to be a case of protein
malnutrition called Kwashiorkor. Kwashiorkor is characterized by very
low serum albumin levels that lead to edema. Low hemoglobin levels
indicate anemia due to dietary deficiency of iron.
Q.2. A 2.5-year-old child with history of poor eating for the last 1 month and
having intermittent diarrhea was brought to the hospital. The physical
examination showed that he was underweight with retarded growth and his
abdomen was distended, liver was moderately enlarged, and generalized
edema was present. The blood analysis showed:
Hemoglobin–6.2 gm/dl
Total protein–5.2 gm/dl
Albumin–1.6 gm/dl
What is the probable diagnosis?Ans: The child is suffering from protein energy malnutrition (kwashiorkor). The
present case indicates a severe form of malnutrition. The presence of edema,
irritability, dermatitis, enlarged liver with fatty infiltration, inadequate
growth, muscles loss, vomiting, and diarrhea are classical symptoms of
kwashiorkor.
39.5 Case Studies of Gout/Uric Acid.......................
Q.1. A 45-year-old, alcoholic patient was complaining of severe pain in joints
and toes. His laboratory report for blood analysis presented:
Sugar (random)–88 mg/dl
Uric acid–9.8 mg/dl
Urea–40 mg/dl160 39 Some Important Case Studies