These are usually seen in kwashiorkor and marasmic kwashiorkor:
- Serious infections, especially septicaemia or pneumonia. Gastroenteritis, tuberculosis, measles and AIDS often precipitate kwashiorkor.
- Hypoglycaemia due to loss of energy stores
- Heart failure due to a small, weak heart
- Bleeding, usually purpura
- Anaemia due to protein and iron deficiency
- Electrolyte imbalances, especially potassium deficiency
- Tremors (‘kwashi shakes’)
- Sudden death
About 25% of children with kwashiorkor die despite treatment. The long-term effect of severe malnutrition on growth and mental development remain uncertain as these children are also affected by a deprived environment.
Hypoglycaemia, hypothermia, infection and heart failure are the main causes of death in severe malnutrition.
Children with kwashiorkor have a low serum albumin, potassium, magnesium, sodium, copper and zinc. Also low glucose, transferrin and clotting factors.