biochemical changes in pem
TRANSCRIPT
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1.Carbohydrate
• Patient develop hypoglycemia d/t
decrease glycogen storage in liver
and muscle.
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2.Fat
• Cholesterol content of body
decreases.
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3.Protein
• Protein content of body also
decreases.
• (A)albumin-there is mainly fall in
albumin
• Patient develop edema if it is below
2.5g
• (B)globulin-normal
• (C)transferrin-markedly reduced in
severe P.E.M.
• (D)urinary urea excretion decreases
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(E)Blood urea :- decreases
(F)Serum Pre albumin :-
It is a sensitive indicator of protein
status in body.
At the beginning of nutritional
therapy it returns to normal.
(G)All essential amino acid:-
Decreases
Non essential amino acid level
normal or decreases .
RATIO of essential and non
essential amino acid increases.
(H)24hr urinary 3-methyl Histidine
excretion dercreased.
.
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(i)Urinary Creatinine Height
Index (C.H.I):-
It is equal to 24hr Urine
Creatinine of affected child
divided by 24hr Urine
creatinine of normal child of
same height.
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P.E.M C.H.I
kwashiorkar 0.25-0.75
Marasmus 0.33-0.85
Recovered child ~1
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Electrolyte level
• Water content of body
decreases
• Hyponatremia
• Hypokalemia
• Mg , Zn, Mn, ceruloplasmin
decreases
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Vitamins and
minerals deficiency
• Deficiency in Vit A, Vit K
• Deficiency in Zn ,Cu , Fe
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Endocrine
• Insulin- impaired serum insulin
level
• Glucagon- increased
• Cortisol – increased
• Growth hormone-increased
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