The anaemia of kwashiorkor in Uganda

Abstract

A significant anaemia, progressively greater with the severity of the general condition, was found to accompany kwashiorkor. It was partly masked by haemoconcentration when the child was admitted, but later became more evident as the serum albumin increased, probably because the blood volume was enlarged. The anaemia resulted from diminished erythroid activity in the bone marrow, which was believed to be an effect of the impaired protein metabolism. Reticulocyte and platelet counts were low. If hookworm or malaria parasites were present, there was more anaemia. Treatment with milk diets caused an increase in marrow activity which gradually corrected the anaemia. There was a remarkable thrombocytosis. The increased activity appeared to be due to the protein of the diets, not to vitamins or haematinics. Of the 100 children examined, 15 were megaloblastic on admission, or became so later. In 5 children loaded with histidine, FIGLU was not excreted until the block in the metabolism of this amino acid was corrected. The excretion stopped after the injection of folic acid.