Cystic fibrosis presenting as kwashiorkor in a Sri Lankan infant.(Short Report)

Growth failure is a common presentation of patients with pancreatic insufficient cystic fibrosis. However, full blown kwashiorkor is extremely rare. Cystic fibrosis is also considered to be rare in the South Asian population. This report describes a Sri Lankan infant with cystic fibrosis who presented with clinical features of severe kwashiorkor.

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Protein energy malnutrition results in a group of disorders, including marasmus and kwashiorkor. Kwashiorkor, caused by decreased protein availability, results in oedema, muscle wasting, skin and hair changes, irritability, and anorexia. (1) In developing countries it occurs mainly as a result of primary protein calorie malnutrition. However, in developed countries, it usually arises as a result of chronic disease rather than primary nutritional deprivation. (2)

Cystic fibrosis (CF) frequently presents in infancy with failure to thrive. While a subset of children with CF present with oedema and hypoalbuminaemia, it has rarely been associated with full blown manifestations of kwashiorkor. (3) CF is the most common inherited autosomal recessive disease in the Caucasian population, but is considered rare in the Indian subcontinent population. (4) This report highlights the importance of considering CF in an infant of non-Caucasian origin presenting with severe kwashiorkor.

CASE REPORT

A 3 month old male, born at term to …