Biochemical Changes in Liver Associated with Kwashiorkor1

Abstract

Kwashiorkor, the most prevalent form of se- vere protein malnutrition, is a serious disease, often fatal to young children and especially common from weaning to five years of age.There are insufficient data concerning the chemical changes which take place during development of the dis- ease, although clinical information is extensive.Present knowledge about various aspects of the disease has been reviewed by Trowell, Davies, and Dean (1), by Brock (2, 3) and more recently by Scrimshaw and co-workers (4).Its biochemical characteristics include low levels of serum pro- tein, amylase, alkaline phosphatase, pseudo-cholin- esterase, cholesterol, riboflavin and vitamin A. Concomitantly the livers are usually found to be high in fat and low in protein.Waterlow (5, 6) did pioneering work on en- zymes in liver biopsy specimens from malnour- ished children and reported that hepatic lactic dehydrogenase and cytochrome oxidase of four children in Gambia remained virtually unchanged after treatment whereas pseudo-cholinesterase was initially low but more than doubled on treat- ment.Later, Waterlow and Patrick (7, 8) stud- ied levels of eight enzymes in liver biopsy samples from a large number of malnourished children in