EFFECTS OF REFEEDING ON SERUM IMMUNOGLOBU LIN CONCENTRATIONS (IGA, IGG, IGM) IN CHILDREN SUFFERING FROM SEVERE PROTEIN-ENERGY MALNUTRITION

Background - Published studies on the serum immunoglobulin concentrati ons of patients with protein-energy malnutrition (PEM) have been contr adictory. This report describes such a study in 21 Senegalese children . Population and methods. - Twenty one Senegalese infants (mean age: 1 9 +/- 2 months) with severe PEM were included in tile study. Their wei ght was less than 32% of the normal range-for-height and all had spars e, thin hair and dyspigmentation of the skin. They were all suffering from hypoproteinemia (less than 70% of normal) and hypoalbuminemia (le ss that 61% of normal). The presence or absence of edema, loss of subc utaneous fat and mental changes were used to classify them into three groups. 1) kwashiorkor: eight infants; 2) marasmus: eight infants: 3) kwashiorkor plus marasmus: five infants. Tile control group comprised 27 infants living in de same area and having the same dietary habits a s the 21 sick infants. The 21 infants with malnutrition were refed for 3 weeks with a diet supplying 100-150 Kcal/kg/d and 5-8 g/kg/d protei n. The plasma concentration of proteins, prealbumin and immumogloblins was measured on days 0, 8, 15 and 21. Results. - The only significant change, was in the Ige concentrations of group I, which increased to normal levels by day 15 as did the total protein and prealbumin. Concl usion. - Severe PEM can lend to a loss of one class of immumoglobulins , but this can be restored by refeeding.