Cutaneous presentation of kwashiorkor due to infantile Crohn's disease

Eur J Pediatr. 2010 Jan;169(1):117-9. doi: 10.1007/s00431-009-0981-5. Epub 2009 Apr 8.

Abstract

Kwashiorkor is one of the severe forms of protein-energy malnutrition. Many characteristic dermatoses can be seen in children suffering from kwashiorkor, and some are pathognomonic. Here, we report an infant who presented with diarrhea and skin signs of kwashiorkor, and duodenal biopsy was consistent with Crohn's disease. The patient was treated with prednisolone administered orally in a tapering course plus azathioprine, in addition to nutritional supplementation. The general condition of the patient quickly improved and his skin lesions completely resolved within 2 weeks. Kwashiorkor is a serious potentially fatal disease that occurs less often in developed countries leading to low index of suspicion by physicians and pediatricians in those regions. Occasionally, dermatologists have the rare chance of alerting pediatricians to the diagnosis of kwashiorkor, thus making a difference in the care of this disease.

Publication types

  • Case Reports

MeSH terms

  • Administration, Oral
  • Azathioprine / administration & dosage
  • Crohn Disease / complications*
  • Crohn Disease / diagnosis
  • Diagnosis, Differential
  • Dose-Response Relationship, Drug
  • Drug Therapy, Combination
  • Follow-Up Studies
  • Glucocorticoids / administration & dosage
  • Humans
  • Immunosuppressive Agents / administration & dosage
  • Infant
  • Kwashiorkor / diagnosis
  • Kwashiorkor / etiology*
  • Kwashiorkor / therapy
  • Male
  • Parenteral Nutrition / methods
  • Prednisolone / administration & dosage
  • Skin / pathology*

Substances

  • Glucocorticoids
  • Immunosuppressive Agents
  • Prednisolone
  • Azathioprine