INTRAVENOUS AMINO-ACIDS, CHOLESTASIS AND KWASHIORKOR

Kwashiorkor dermatosis has not been reported in children on parenteral nutrition (PN). We report a case of kwashiorkor developing in a parti ally PN dependent patient with cholestasis, when amino acids were remo ved from the PN solution in an effort to control the cholestasis. Alth ough the kwashiorkor dermatosis improved within 24 hours after the add ition of amino acids (I g/kg) to the PN solution, the cholestasis wors ened. This case demonstrates that kwashiorkor can be induced and treat ed, respectively, by withholding and supplying intravenous amino acids . This suggests a need to minimize delivery of amino acids in children with PN-associated cholestasis.