Pituitary adrenal axis status in children with protein calorie malnutrition [PCM]

ABSTRACT

Thirty six children suffering from various forms of protein calorie ma1nutrition [PCM] [15 with marasmus, 9 with kwashiorkor and 12 with marasmic kwashiorkor] Their ages ranged in between 4 to 20 months, beside 10 healthy children of matched age and sex were similarly taken as a control group. The following investigations [serum Na and K. plasma ACTH, serum cortisol and aldosterone] were performed. There were [1] Increased serum cortisol levels with loss of diurnal variation in all groups of PCM [2] Increased plasma ACTH levels in all groups of PCM. [3] Incomplete dexamethasone suppression [4] variable changes in the levels of serum aldosterone among various forms of PCM. In marasmic group mean serum aldosterone level was within normal, but the mean levels were significantly higher in both kwashiorkor and marasmic kwashiorkor groups. After nutritional rehabilitation the levels of these hormones returned to normal indicating that these changes are protective mechanisms as well as easy reversibility of the axis