On malnutrition in childhood in the Philippines III. pathological findings in malnutrition in the Philippines

ABSTRACT

The histologic changes in different organs of 32 Filipino infants who died in a state of severe malnutrition were studied. Changes in the intestines, liver and pancreas which have already been described were confirmed. A significant finding was that hemorrhage had occurred in some organs in a total of 29 (91%) of the cases. The frequency distribution of hemorrhages in various organs is as follows adrenals (medulla) - 26 (81%); bone marrow - 16 (50%); kidneys - 13 (41%); lungs - 13 (41%); liver - 7 (22%); pituitary gland - 5 (16%); heart muscle, thymus, and lymph nodes - 2 cases each (6%); and testes - 1 (3%). The brain was not studied in most of these casesThese findings are interpreted to indicate a general hemorrhagic tendency among cases of severe malnutrition in Filipino infants; furthermore, massive hemorrhages in the adrenal medulla is apparently the cause of death in a high percentage of these cases. The underlying mechanism of this hemorrhagic tendency has yet to be clarifiedHyperemia found in different organs suggests impairment of cardiac function which cannot be detected by electrocardiography as the entire heart muscle seems to be involved. Histologically evident infections seem to play only a minor role in malnutrition; however, complete bacteriologic study of malnutrition cases is strongly indicated. Degenerative changes in the kidney with discharge of a hyaline material into the tubules was observed in about one-half of the cases. (Summary and Conclusions)