Protein energy malnutrition

Protein-Energy Malnutrition Nutrition Guide for Clinician

Protein-Energy Malnutrition Protein-energy malnutrition (PEM) is classically described as 1 of 2 syndromes, marasmus and kwashiorkor, depending on the presence or absence of edema. Each type may be classified as acute or chronic. Additionally, marasmus can precede kwashiorkor Protein-energy malnutrition (PEM), sometimes called protein-energy undernutrition (PEU), is a form of malnutrition that is defined as a range of conditions arising from coincident lack of dietary protein and/or energy (calories) in varying proportions. The condition has mild, moderate, and severe degrees Protein-energy malnutrition or PEM is the condition of lack of energy due to the deficiency of all the macronutrients and many micronutrients. It can occur suddenly or gradually. It can be graded as mild, moderate or severe. In developing countries, it affects children who are not provided with calories and proteins Amongst, the prevalence of nutritional problems especially protein-energy malnutrition (PEM) and micronutrients deficiencies are the rising issues. Moreover, the immunity or susceptibility to infect-parasitic diseases is also directly linked with the nutritional status of the host

Protein-energy malnutrition - Wikipedi

Protein-energy malnutrition is a nutritional deficiency resulting from either inadequate energy (caloric) or protein intake and manifesting in either marasmus or kwashiokor. Marasmus is characterised by wasting of body tissues, particularly muscles and subcutaneous fat, and is usually a result of sever Protein-energy malnutrition is a term that describes pathological conditions resulting from a deficiency of dietary protein and/or total calories. Primary PEM: due to inadequate macronutrient intake . Marasmus: due to deficiency of all macronutrients; Kwashiorkor: due to protein deficienc Protein-energy undernutrition (PEU), previously called protein-energy malnutrition, is an energy deficit due to deficiency of all macronutrients. It commonly includes deficiencies of many micronutrients. PEU can be sudden and total (starvation) or gradual Protein-energy malnutrition (PEM) is composed of a spectrum of biological disorders caused by the lack of food. Despite the name, it is not necessary for affected individuals to be experiencing a lack of protein, but rather a deficiency of total energy In discussing that protein-energy malnutrition is highly prevalent among peritoneal dialysis patients, Chung et al noted that although nutritional status assessments had improved over the decade from 1997 to 2007, no definitive single test was available to assess nutritional status. [] Instead, they proposed that several different markers of nutrition must be used to understand nutritional status

Protein Energy Malnutrition (PEM) describes a spectrum of clinical conditions with varying feature and biochemical findings. At one end is Marasmus (protein-calorie malnutrition), a syndrome related chronic dietary restriction of energy, protein and other nutrients. Marasmus is associated with diseases such as anorexia nervosa, GI cancer. Protein Energy Malnutrition (PEM) February 9, 2020 | by Yashaswi Pathakamuri | Posted in Nutrition Facts. Protein energy malnutrition ids also known as protein-calorie malnutrition. The two common clinical syndromes due to severe protein-calorie malnutrition in young children are kwashiorkor and marasmus.Both the conditions are caused by severe deficiencies of protein and calories in diet Protein-energy malnutrition (PEM) is common in connection with chronic disease and is associated with increased morbidity and mortality. Because the risk of PEM is related to the degree of illness, the causal connections between malnutrition and a poorer prognosis are complex

Keep in mind that edema is a symptom of severe protein deficiency, which is unlikely to happen in developed countries. Summary: Key symptoms of kwashiorkor are edema and a swollen abdomen. 2. PROTEIN ENERGY MALNUTRITION (PEM) The term protein energy malnutrition covers a wide spectrum of clinical stages ranging from the severe forms like kwashiorkar and marasmus to the milder forces in which the main detectable manifestation is growth retardation.It is widely prevalent among weaned infants and pre-school children in India and other developing countries 3.  PROTEIN ENERGY MALNUTRITION It is a group of body depletion disorders which include kwashiorkor, marasmus and the intermediate stages MARASMUS Represents simple starvation Protein Energy Malnutrition (PEM) is defined as a range of pathological conditions arising from coincident lack of varying proportions of protein and calorie. Effects of protein deficiency Diseases due to the deficiency of proteins and calories occur commonly among weaned infants and pre-school children in India and other developing countries

Protein Energy Malnutrition

What Is Protein Energy Malnutrition? Classifications Of PE

Protein-energy malnutrition: a risk factor for various

Protein-energy malnutrition (PEM)/undernutrition and frailty are prevalent, overlapping conditions impacting on functional and health outcomes of older adults, but are frequently unidentified and untreated in community settings in the United States. Using the World Health Organization criteria for effective screening programs, we reviewed. Protein-energy malnutrition is the most common form of nutritional deficiency among patients who are hospitalized in the United States. As many as half of all patients admitted to the hospital have malnutrition to some degree. In a recent survey in a large children's hospital, th

Protein-energy malnutrition is a spectrum of biological disorders as a result of a lack of adequate food. Previously, called protein-calorie malnutrition (PCM). Most predominantly seen in weaned infants and preschool children. Rarely seen in developed countries. Sometimes they are life-threatening when left untreated With protein-energy malnutrition (PEM) being implicated in about 60% of all child deaths, the republishing of this book by John Waterlow is timely and necessary. Because the evidence indicates that most malnourished children die because of poor pediatric care by inappropriately trained medical staff, the new cover design depicting the 10. It is evident that nutrients must be ingested and utilized in sufficient amounts to serve as metabolic fuel and as a substrate for tissue growth; if a macronutrient (protein, energy) or an essential nutrient (amino acids, fatty acids, vitamins and trace minerals) is provided in insufficient amounts, this will sooner or later result in malnutrition SEVERE ACUTE MALNUTRITION • Severe Acute malnutrition is defined as the presence of severe wasting - Weight for height/length <‐3SD and or - MUAC <11.5 cm for children 6‐59 months and or - Presence of bilateral edema • Children with severe acute malnutrition hav


WHO The worldwide magnitude of protein-energy

Protein energy malnutrition (PEM) is one of the most important public health problems in many developing countries including India, South East Asia and Africa. It is a wide-spread deficiency disease among children of low socio-economic groups. In many areas nearly half the children do not survive to the age of five years on account of protein. the medical record and for coders to be aware of malnutrition as a potential diagnosis (ICD-9-CM Code Categories 262 and 263). The most severe malnutrition problems are associated with Protein-Calorie Malnutrition (PCM), also known as Protein-Energy Malnutrition (or Protein Calorie Undernutrition), which occurs in both chronic and acute forms protein‐energy malnutrition (PEM) A spectrum of disorders, especially in children, due to inadequate feeding. Marasmus is severe wasting and can also occur in adults; it is the result of a food intake inadequate to meet energy expenditure

Figure \(\PageIndex{19}\): The 2 types of protein-energy malnutrition. Kwashiorkor is a Ghanaian word that means the disease that the first child gets when the new child comes39. The characteristic symptom of kwashiorkor is a swollen abdomen. Energy intake could be adequate, but protein consumption is too low.. Sir.—In our institution as in The Children's Memorial Hospital in Chicago, the use of the term nonorganic failure to thrive obscures the fact that treatable protein-energy malnutrition is a common disorder. We support Listernick and his colleagues 1 in their contention that this term should be discarded.. All children who receive even the most rudimentary health care should be properly. Protein Energy Malnutrition (PEM) is a clinical syndrome that is characterized by multiple of progressively worsening nutrient deficiencies. Paramount to the recognition and classification of PEM is weight loss (Frongillo Jnr., 1999). Moreover, PEM is understood generally to include severe clinical malnutrition (Kwashiorkor, Marasmus, and mixed. Protein-energy malnutrition represents a shift of the body from fed to fasting/starvation state. Starvation leads to a decreased basal plasma insulin concentration and in decrease of glucose -stimulated insulin secretion. Prolonged fasting results in a deficiency in amino acids used for gluconeogenesis

Protein-energy Malnutrition - Overview, Symptoms

Protein Energy Malnutrition. The ICD-10-CM Alphabetical Index is designed to allow medical coders to look up various medical terms and connect them with the appropriate ICD codes. There are 3 terms under the parent term 'Protein Energy Malnutrition' in the ICD-10-CM Alphabetical Index Protein energy malnutrition sends more preschool children to premature graves here, than in Bangladesh, India or Pakistan, the World Bank and Asian Development Bank confirm in their joint report Early Childhood Development. Lack of micronutrients saps intelligence quotients

The consequences of malnutrition are serious. In older adults, for instance, it can lead to a weakened immune system, increased risk of death and decreased bone mass, according to the Mayo Clinic.And in kids, it causes developmental delays and other major problems, per the Academy of Nutrition and Dietetics ICD-10-CM Diagnosis Code E46. E46 Unspecified protein-calorie malnutrition. ICD-10-CM Diagnosis Code E44.0 [convert to ICD-9-CM] Moderate protein -calorie malnutrition. Moderate protein-calorie malnutrition (weight for age 60-74% of standard); Protein calorie malnutrition, moderate. ICD-10-CM Diagnosis Code E44.0 PROTEIN ENERGY. MALNUTRITION (PEM) MALNUTRITION Results. from a lack of one or more essential nutrients (nutritional deficiency) or from an excessive nutrient supply to the point of creating toxic or harmful effects (obesity/adiposity). FORMS OF MALNUTRITION UNDERNUTRITION-results. from the consumption of a Protein - Energy Malnutrition (PEM) STUDY. Flashcards. Learn. Write. Spell. Test. PLAY. Match. Gravity. Created by. ortracy11. Key Concepts: Terms in this set (26) primary is when there is an inadequate protein intake and secondary is when disease states lead to protein deficiency

Protein-Energy MalnutritionCausesSymptomsTreatment

  1. Malnutrition, in particular protein-energy malnutrition, is a highly prevalent condition in older adults, and is associated with low muscle mass and function, and increased prevalence of physical frailty. Malnutrition is often exacerbated in the residential care setting due to factors including lack of dentition and appetite, and increased.
  2. Protein energy malnutrition (PEM) is a major nutritional disorder particularly in developing countries of the world. This condition most often occurs in infants and children hence the disorder is also called infantile pellagra, nutritional edema etc. Cicely Williams while working in Ghana in 1930 described this condition in detail
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  4. Protein-energy malnutrition (PEM) is common among elderly adults and people with chronic illness. It is a result of insufficient energy and protein intake to meet the body's needs, causing weight loss and wasting of muscle and fat stores . Historically, there is a lack of consensus on the definition of malnutrition and which clinical.

What Is Protein Energy Malnutrition In Public Health, what is Kawishkor and Marasmus.?#marusmus#Kawishkoor#publichealthFOLLOW ME ON FACEBOOK = https://www.fa.. This is the video on one of the most common nutritional disorder i.e. Protein Energy Malnutrition (PEM) with examples of theory question and NEET PG MCQs00:0.. Monitoring nutrition and preventing malnutrition. As a caregiver or adult child of an older adult, you can take steps to monitor nutritional health, watch for weight loss and address risk factors of malnutrition. Consider the following: Monitor weight. Help the older adult check his or her weight at home. Keep a weekly record Protein-energy malnutrition (PEM) has adversely affected the generations of developing countries. It is a syndrome that in severity causes death. PEM generally affects infants of 1-5 age group. This manifestation is maintained till adulthood in the form of poor brain and body development. The developing nations are continuously making an effort to curb PEM

Answer: A. Severe malnutrition is present. The patient has severe malnutrition from inflammatory bowel disease, with significant weight change and altered bowel habit. In addition, the albumin level, if checked, will be low, but this finding does not in itself define protein-energy malnutrition Micronutrient deficiencies and protein-energy malnutrition. Before 1980, most attention given to nutrition in developing countries focused on protein-energy malnutrition (PEM). The culmination of this attention was the era of multisectoral nutrition planning in the 1970s. In retrospect, those of us who pursued multisectoral planning met with. Treatment of Protein-energy malnutrition. May 23, 2021 May 24, 2021 Ayenew. Categories Uncategorized Tagged Kwashiorkor, Protein-energy malnutrition. Spread the love. Treatment of Protein-energy malnutrition Educational objective. Identify criteria's to start feeding Classification of protein-energy malnutrition There are two basic forms of clinical protein-energy malnutrition­ marasmus and kwashiorkor-and a mixed form, marasmic kwashior­ kor. The leading signs for a diagnosis of marasmus are those of starva­ tion: an old man's face, an emaciated body that is only skin an The lack of sufficient energy or protein to meet the body's metabolic demands, as a result of either an inadequate dietary intake of protein, intake of poor quality dietary protein, increased demands due to disease, or increased nutrient losses. Terms. Protein-Energy Malnutrition Preferred Term. Term UI T033981

PEM or Protein-energy malnutrition is a condition resulting in lack of energy as a result of inadequate supply of several micronutrients and all macronutrients which could either occur gradually or as a sudden change. PEM can be classified into - Primary PEM and Secondary PEM. Solve some questions on Protein-energy malnutrition provided below. 1 However, known risk factors for pressure ulcer development include compromised nutritional status (unintentional weight loss, undernutrition, protein energy malnutrition, and dehydration), as well as low body mass index, reduced food intake, and impaired ability to eat independently To evaluate (1) the prevalence of protein-energy malnutrition in elderly patients; (2) the changes in nutritional status during the hospital stay; and (3) (main objective) the relationship between simple nutritional parameters and short-term in-hospital mortality. Design. Prospective time series at admission and on the 15th day of hospitalization Protein-energy malnutrition @'EM) can be a life-threatening situation, because it can lead to an immune deficiency that increases susceptibili- ty to infections. It appears that cell- mediated immunity is the most seri- ously affected (Parent, Chevalier, Yulles, et al., 1994). Severe malnutri Protein-energy malnutrition in children Clinical characteristics The term protein-energy malnutrition (PEM) was first introduced in relation to children and it is worth pausing to look at the history of this name. Richard Asher (3) has remarked that a disease does not exist until it has a name

Protein Calorie Malnutrition - an overview ScienceDirect

Protein Energy Malnutrition as the name suggests is lack of protein and energy resulting from poor nutrition. Causes of Protein Energy Malnutrition In Adults . Insufficient food intake.. Anorexia.. Persistent regurgitation or vomiting.. Depletion of electrolytes - sodium, potassium and magnesium from diarrhea PEM = protein-energy malnutrition. Photo by: Lianne Friesen and Nicholas Woolridge A logical, but inadequate, way to classify the severity of PEM is simply by degree of weight loss. 10 This requires estimation of the patient's dry weight (weight corrected for edema or ascites) and a calculation of what percentage this is of normal for.

Protein energy malnutrition (PEM) is one of the most common undernutrition conditions leading to high mortality and morbidity rate among children influencing greatly the skeletal and dental development as well. The aim of the study was to find out the prevalence of PEM among pre- school children and its association with eruption of primary teeth In nutritional disease: Protein-energy malnutrition. Chronic undernutrition manifests primarily as protein-energy malnutrition (PEM), which is the most common form of malnutrition worldwide. Also known as protein-calorie malnutrition, PEM is a continuum in which people—all too often children—consume too little protein, energy, or both Protein-energy malnutrition is caused by an inadequate consumption of calories, resulting in a deficiency of proteins and micronutrients (nutrients required in small quantities, such as vitamins and trace minerals). Rapid growth, an infection, an injury, or a chronic debilitating disease can increase the need for nutrients, particularly in. Protein-Energy Malnutrition. Spectrum of conditions caused by varying levels or protein and calorie deficiencies. Primary PEM caused by social or economic factors that result in a lack of food. Secondary PEM occurs in children with various conditions associated with increased caloric requirements (infection, trauma, cancer), increased caloric. Protein Energy Malnutrition, Endemic Goitre, Nutritional Anaemia, Nutritional Blindness and Diarrhoeal Diseases (2). While attention was concentrated on nutrition deficiency diseases during the first decades of the 20 th century, the science of nutrition was extending its influence into other fields as well like agriculture, animal husbandry.

High risk factor for malnutrition in children: Age of mother: 18 - 23 yrs Female gender Rural area Birth order > 3 Birth spacing < 47 months Low birth weight Illiterate mother Scheduled caste/ scheduled tribe Underweight status of mothers: International Institute for Population Sciences (IIPS) and Macro International. 2007. National Family Healt Protein-energy malnutrition occurs as a result of a relative or absolute deficiency of energy and protein. It may be primary, due to inadequate food intake, or secondary, as a result of other illness. For most developing nations, primary protein-energy malnutrition remains among the most significant health problems Protein-energy malnutrition (PEM) can be determined by anthropometric measures and laboratory values: BMI of > or equal to 19 to < 22-considered at risk for malnutrition. BMI of <19-considered to be malnourished. Unintentional weight loss of >10% of body weight in the last 6 months or >5% weight loss in the last 3 months

Protein-energy malnutrition - AMBOS

P EM or Protein-Energy Malnutrition is a macro-nutrient deficiency rather than micro-nutrient deficiency. It is actually a combination of two pediatric diseases very commonly encountered, Kwashiorkor and Marasmus. While the Marasmus occurs due to energy deficiency, Kwashiorkor is attributed to protein deficiency, the two being most common in children Protein-energy malnutrition affects children the most because they have less protein intake. The few rare cases found in the developed world are almost entirely found in small children as a result offad diets, or ignorance of the nutritional needs of children, particularly in cases of milk allergy.[5 Background • WHO defines malnutrition as the cellular imbalance between th supply of nutrients and the body's demand for them to ensure growth, maintenance and specific functions • Malnutrition encompasses both ends of the spectrum (under nutrition to overweight) • Protein energy malnutrition (PEM) applies to a group of disorder includes marasmus, kwashiorkor, and marasmic. Protein energy malnutrition. Many of the children in this photograph from a Nigerian orphanage in the late 1960's show symptoms of malnutrition, with four in particular illustrating the gray-blond hair symptomatic of kwashiorkor. ICD - 10. E44.0 E44.0 PROTEIN ENERGY MALNUTRITION Definition Malnutrition: The World Health Organization defines malnutrition as the cellular imbalance between supply of nutrients and energy and the body's demand for them to ensure growth, maintenance, and specific functions. PEM: Invariably reflects combined deficiencies in protein, energy and micronutrients Nutrition: It is the provision of adequate energy and.

Current knowledge and understanding of protein energy malnutrition (PEM) are reviewed in this comprehensive 20-chapter text. Among the major subjects addressed are: body composition and body water; electrolytes and major minerals; effects of PEM on structure and function of organs; metabolic changes; biochemical measurements for the assessment of PEM; endocrine changes in severe PEM; trace.. PROTEIN-ENERGY MALNUTRITION. Presented by Wiraharto 090100034 Ismail Lubis 080100152 Supervised by Dr. Hj. Melda Deliana, Sp.A(K) DEPARTEMEN ILMU KESEHATAN ANAK PROGRAM PENDIDIKAN PROFESI DOKTER FAKULTAS KEDOKTERAN UNIVERSITAS SUMATERA UTARA 2013 DEFINITION Malnutrition (WHO): the cellular imbalance between the supply of nutrients and energy and the body's demand for them to ensure growth.

Protein energy malnutrition among children

Protein-Energy Undernutrition (PEU) - Nutritional

Kwashiorkor, also known as edematous malnutrition because of its association with edema (fluid retention), is a nutritional disorder most often seen in regions experiencing famine Okay, let's switch gears and discuss protein-energy malnutrition, which is a lack of energy that results from inadequate intake of protein or total calories. For your exams, remember that this most commonly occurs in resource-limited regions of Sub-Saharan Africa, South-East Asia and Central America, and has two major forms: Kwashiorkor and. For one thing, TB leads to malnutrition worse, protein-energy malnutrition, micronutrient deficiencies, be in a catabolic state, weight loss or low body mass index (BMI), loss of appetite, and fatigue.[sup][5],[6],[7] For another perspective, malnutrition is believed to make people more susceptible to TB and to delay recovery by impairing cell. Protein-Energy Malnutrition Known as: Malnutrition, Protein-Energy , Unspecified protein-calorie malnutrition , Malnutrition, Protein-Calorie Expand The lack of sufficient energy or protein to meet the body's metabolic demands, as a result of either an inadequate dietary intake of protein, intak

Summary. In developed countries, medical conditions, rather than lack of food, are the main contributors to malnutrition. Undernutrition is especially common in older persons, occurring in 5-12% of community-dwelling older persons, in 30-61% of hospitalized older persons, and in 40-85% of persons in long-term care institutions Marasmus / Protein-Energy Malnutrition. Marasmus is a condition of chronic malnutrition caused by a diet deficient in calories and proteins. Loss of body fat and muscle tissue leads to a skin and. The prevalence of protein and protein-energy malnutrition in a population of geriatric rehabilitation patients at SCO Health Service - Body weight, body fat and protein stores, lab values. Definitions vary within. / Protein-Energy Malnutrition. Goldman's Cecil Medicine: Twenty Fourth Edition. Goldman's Cecil Medicine: Twenty Fourth Edition. Vol. 2 Elsevier Inc., 2011. pp. 1388-139

Protein-energy malnutrition occurs in 50% of surgical patients and in 48% of all other hospital patients. There is an increased risk of malnutrition associated with chronic diseases, especially disease of the intestinal tract, kidneys, and liver. Patients with chronic diseases like cancer, AIDS, and intestinal disorders may lose weight rapidly. What are the complications of severe malnutrition? These are usually seen in kwashiorkor and marasmic kwashiorkor: Serious infections, especially septicaemia or pneumonia. Gastroenteritis, tuberculosis, measles and AIDS often precipitate kwashiorkor. Hypoglycaemia due to loss of energy stores. Hyothermia. Heart failure due to a small, weak heart One of the key challenges that we face in the 21st century is the need to feed an ever-increasing human population with increasingly limited natural resources. Even today it is estimated that roughly 1 out of 9 people in the world are undernourished, of which the most important factor is protein-energy malnutrition Kwashiorkor (wet protein-energy malnutrition) Typically appears around one year of age when breastfeeding stops. Marasmus. Typically appears between six months to one year old in children who no longer breastfeed. Marasmic kwashiorkor. This is the most severe form with obvious protein and calorie malnutrition. Symptoms can occur at any time

Protein-Energy Malnutrition synonyms, Protein-Energy Malnutrition pronunciation, Protein-Energy Malnutrition translation, English dictionary definition of Protein-Energy Malnutrition. n. Poor nutrition because of an insufficient or poorly balanced diet or faulty digestion or utilization of foods. American Heritage® Dictionary of the.. Protein-energy malnutrition (PEM), a condition that affects many elderly individuals, consists of a variety of alterations including decreased intake, increased metabolic rate, increased energy expenditure, and excess nutrient loss. Protein-energy malnutrition occurs when too few calories and/or protein are being supplied to the body because of malnutrition, and from acute conditions, such as. This non-experimental, cross-sectional descriptive study assessed the predisposing factors to protein energy malnutrition among children in Umuogele Umuariam Community, in Obowo Local Government Area of Imo State. The target population comprised all the mothers in Umuogele Umuariam Community, in Obowo Local Government Area who has children (0-5years)

DIETARY MANAGEMENT FOR PROTEIN ENERGY MALNUTRITION Diet plays an important role in the management of Protein Energy Malnutrition (PEM). Nutritional intervention is the primary consideration. Thus, some healthy balanced dietary management tips are recommended for prevention of Protein Energy Malnutrition as following Protein-energy Malnutrition. G. A. O. Alleyne. Edward Arnold, 1977 increased indicate infants infection influence intake Jamaica Jelliffe kwashiorkor Lancet less levels liver loss malnourished children malnutrition marasmus mean measurements method months mother muscle normal Nutr nutrition occur oedema Pediat period plasma possible. Malnutrition means poor nutrition which can be caused by undernutrition or overnutrition. The term is most commonly used to describe undernutrition, which is the focus here. Please see obesity for more information about overnutrition. A balanced diet should provide enough nutrients such as calories, protein and vitamins, to keep you healthy Malnutrition is associated with both structural and functional pathology of the brain. A wide range of cognitive deficits has been reported in malnourished children. Effect of chronic protein energy malnutrition (PEM) causing stunting and wasting in children could also affect the ongoing development of higher cognitive processes during childhood (>5 years of age)

Protein-Energy Malnutrition - an overview ScienceDirect

Protein-Energy Malnutrition Treatment & Management

Protein energy malnutrition frequently occurs in liver cirrhosis. Hand-grip strength according to Jamar is most reliable to predict protein energy malnutrition. We aimed to determine whether protein energy malnutrition affects complication risk. Methods Malnutrition is a significant problem all over the world, especially among children. It is very harmful to children because it affects brain development and other growth. Children who suffer from malnutrition may have lifelong problems

Unspecified severe protein-calorie malnutrition. E43 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2021 edition of ICD-10-CM E43 became effective on October 1, 2020 Protein-energy malnutrition (PEM), now known as protein-energy undernutrition, is an energy deficit due to chronic deficiency of all macronutrients . In children, PEM causes widespread atrophy of lymphoid tissues, particularly T-lymphocyte areas. The thymus involutes causing a reduction in the thymus-derived lymphocyte growth and maturation.