Edema is a condition that involves the collection of fluid under the skin or in the cavities that surround your body's organs. While there are numerous causes and types, edema in the feet and abdomen may arise due to protein malnutrition in young children. Known as kwashiorkor, or edematous malnutrition, this condition is prevalent throughout tropical Africa and South Asia, though relatively rare in North America.
Kwashiorkor
The name "kwashiorkor" comes from the Ga language of Ghana and means "the disease of the deposed child," according to a team led by Tahmeed Ahmed at the International Centre for Diarrhoeal Disease Research in Dhaka, Bangladesh. In the November 2009 issue of the "Indian Journal of Medical Research," these researchers state that the name of this condition arises from the use of protein-poor gruel to wean young children off of breast milk. As this typically occurs when a new baby is born, this leads to the older, "deposed" sibling receiving inadequate amounts of protein, eventually leading to the development of edema due to malnutrition.
Symptoms and Causes
Edema in the feet is the defining symptom of kwashiorkor, though other symptoms include a swollen abdomen, swollen liver, thinning hair, tooth loss, skin conditions and irritability. As children who receive adequate amounts of protein, calories, vitamins and minerals do not develop this condition, general malnutrition is necessary for the development of kwashiorkor. As Ahmed and his colleagues note, however, this malnutrition is not sufficient to cause kwashiorkor. Noting that children who develop other malnutrition-related conditions have similar deficiencies of these nutrients, they suggest that other factors are necessary for the development of edema.
Other Factors
According to Ahmed and his colleagues, kwashiorkor is typically associated with low levels of antioxidants and high levels of iron circulating in the body. Although they note that there is no evidence that these conditions lead to kwashiorkor, treatment with antioxidants helps to reduce swelling due to edema. They also point out that children with kwashiorkor tend to have problems regulating levels of anti-diuretic hormone, or ADH, in their body. As this hormone prevents your body from ridding itself of excess water, consistently high levels of ADH can cause edema in these children.
Infection
Although malnutrition exists elsewhere, kwashiorkor is almost exclusively limited to tropical areas. Ahmed and his colleagues point out that edematous malnutrition is almost always accompanied by another infection, with the moist, warm environment of tropical regions hosting a range of infectious organisms. As Michael Krawinkel of the University of Giessen, Germany notes, this may be due to aflatoxins, which are toxic molds that can develop on starchy foods. In the December 2003 "Bulletin of the World Health Organization," he notes that these toxins typically affect the liver, potentially explaining the effects of kwashiorkor on the liver. With numerous contributing factors and possible causes, however, edema due to malnutrition in children remains unexplained.
References
- "Indian Journal of Medical Research"; Oedematous Malnutrition; Tahmeed Ahmed et al.; November 2009
- Mother and Child Nutrition: Early Detection and Referral of Children with Malnutrition
- "British Medical Journal"; Antioxidant Supplementation for the Prevention of Kwashiorkor in Malawian Children: Randomised, Double Blind, Placebo Controlled Trial; Heather Ciliberto et al.; April 2005
- "The Journal of Nutrition"; The Development of Concepts of Malnutrition; Michael H. N. Golden; July 2002
- "Bulletin of the World Health Organization"; Kwashiorkor is Still Not Fully Understood; Michael Krawinkel; December 2003
