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HYPOPROTEINOSIS OF CHILDHOOD

Harold D. Lynch, M.D.; William D. Snively, Jr., M.D.
[+] Author Affiliations

Evansville, Ind.


JAMA. 1951;147(2):115-119. doi:10.1001/jama.1951.03670190015004
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For many years we have encountered a repetitious combination of complaints in office practice with children. The familiar list includes poor appetite; failure to gain weight and to grow normally; irritability; frequent gastrointestinal upsets, including vomiting and constipation; repeated bouts of infectious disease; dental caries, and pallor. Frequently when a child has been brought in with one or two of these conditions as presenting symptoms, history and examination have revealed others.

Gradually we came to realize that this combination of complaints is consistently associated with a certain type of dietary history. The child's diet is nearly always adequate in minerals and vitamins but is not adequate in protein. Ordinarily milk and carbohydrate foods are taken in large quantities, but meat, eggs, and other protein foods are neglected. Prompt and dramatic response to provision of adequate protein has established this syndrome, in our minds, as a true deficiency disease.

Surprisingly little

REFERENCES

Clements, F. W.:  Some Aspects of Protein Metabolism in Infants and Children , M. J. Australia 2:404-409 ( (Sept. 21) ) 1946;.
Wolpe, L. Z.:  Blood Protein Depletion in Infantile Eczema , California Med. 67:156-159 ( (Sept.) ) 1947;.
Petrides, E. P.:  Hunger Edema in Children , J. Pediat. 32: 333-350 ( (April) ) 1948;.
Miranda, F. de P.:  Nutrition and Endocrinology with Special Reference to the Nutrition of the Mexican Indian , J. A. M. A. 136: 542-545 ( (Feb. 21) ) 1948;.
Holt, L. E.: The Diseases of Infancy and Childhood , New York, D. Appleton & Company, 1898;, p. 287.
Cannon, P. R.:  Protein Metabolism and Acquired Immunity , J. Am. Diet. A. 20:77-80 ( (Feb.) ) 1944;.
Cannon, P. R.; Wissler, R. W.; Woolridge, R. L., and Benditt, E. P.:  The Relationship of Protein Deficiency to Surgical Infection , Ann. Surg. 120:514-525 ( (Oct.) ) 1944;.
Anderson, G. K.:  The Importance of Protein in Diet Therapy , J. Am. Dietet. A. 21:436-439 ( (July-Aug.) ) 1945;.
Guggenheim, K., and Buechler, E.:  Nutrition and Resistance to Infection, the Effect of Quantitative and Qualitative Protein Deficiency on the Bactericidal Properties and Phagocytic Activity of the Peritoneal Fluid of Rats , J. Immunol. 58: 133-139 ( (Feb.) ) 1948;.
Coburn, A. F., and Moore, L. V.:  Nutrition as a Conditioning Factor in the Rheumatic State , Am. J. Dis. Child. 65:744-756 ( (May) ) 1943;.
Pottenger, F. M., Jr., and Pottenger, F. M.:  Adequate Diet in Tuberculosis , Am. Rev. Tuberc. 54:213-218 ( (Sept.) ) 1946;.
Duncan, A. C.:  Diet and Disease in the Subarctic , Lancet 2:919-921 ( (Dec. 20) ) 1947;.
McCance, R. A.; Widdowson, E. M., and Lehmann, H.:  The Effect of Protein Intake on the Absorption of Calcium and Magnesium , Biochem. J. 36:686-691, 1942;.
Shourie, K. L.:  Dental Caries in Indian Children , Indian J. M. Research 29:709 ( (Oct.) ) 1941;.
Elvehjem, C. A.:  A Nutritionist's View of the Caries Problem , J. Am. Dent A. 37:410-415 ( (Oct.) ) 1948;.
Waugh, L. M.:  I. A Study of the Nutrition and Teeth of the Eskimo of North Bering Sea and Arctic Alaska , J. Dent. Research 10:387 ( (June) ) 1930;
 II. A Study of the Nutrition and Teeth of the Eskimo of North Bering and Arctic Alaska , WaughJ. Dent. Research 11:453 ( (June) ) 1931;
 III. Nutrition and Health of the Labrador Eskimo, With Special Reference to the Mouth and Teeth , WaughJ. Dent. Research 8: 428 ( (June) ) 1928;
Elvehjem, C. A.:  A Nutritionist's View of the Caries Problem , J. Am. Dent. A. 37: 410-415 ( (Oct.) ) 1948;.
Himsworth, H. P.:  Protein Metabolism in Relation to Disease, Presidential Address in the Section of Experimental Medicine and Therapeutics of the Royal Society of Medicine; abstracted , Brit. M. J. 2: 662-663 ( (Nov. 2) ) 1946;.
Graham, J. R., and Scott, T. M.:  Notes on the Treatment of Tetanus , New England J. Med. 235: 846-852 ( (Dec. 12) ) 1946;.
Weech, A. A.; Wollstein, M., and Goettsch, E.:  Nutrition Edema in the Dog; V. Development of Deficits in Erythrocytes and Hemoglobin on a Diet Deficient in Protein , J. Clin. Investigation 16:719-728 ( (Sept.) ) 1937;.
Orten, A. U., and Orten, J. M.:  The Role of Dietary Protein in Hemoglobin Formation , J. Nutrition 26:21-31 ( (July) ) 1943;.
Stare, F. J., and Thorn, G. W.:  Council on Foods and Nutrition, Protein Nutrition in Problems of Medical Interest , J. A. M. A. 127: 1120-1127 ( (April 28) ) 1945;.
Darby, W. J.:  Iron and Copper , J. A. M. A. 142: 1288-1295 ( (April 22) ) 1950;.
Bowes, A. deP., and Church, C. F.: Food Values of Portions Commonly Used , ed. 6, 1946;. (Available from Anna dePlanter Bowes, 311 S. Juniper St., Philadelphia 7, Pa.)
Food and Nutrition Board, National Research Council: Recommended Dietary Allowances, Revised 1948, Reprint and Circular Series No. 129 (Oct.) 1948.

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Clements, F. W.:  Some Aspects of Protein Metabolism in Infants and Children , M. J. Australia 2:404-409 ( (Sept. 21) ) 1946;.
Wolpe, L. Z.:  Blood Protein Depletion in Infantile Eczema , California Med. 67:156-159 ( (Sept.) ) 1947;.
Petrides, E. P.:  Hunger Edema in Children , J. Pediat. 32: 333-350 ( (April) ) 1948;.
Miranda, F. de P.:  Nutrition and Endocrinology with Special Reference to the Nutrition of the Mexican Indian , J. A. M. A. 136: 542-545 ( (Feb. 21) ) 1948;.
Holt, L. E.: The Diseases of Infancy and Childhood , New York, D. Appleton & Company, 1898;, p. 287.
Cannon, P. R.:  Protein Metabolism and Acquired Immunity , J. Am. Diet. A. 20:77-80 ( (Feb.) ) 1944;.
Cannon, P. R.; Wissler, R. W.; Woolridge, R. L., and Benditt, E. P.:  The Relationship of Protein Deficiency to Surgical Infection , Ann. Surg. 120:514-525 ( (Oct.) ) 1944;.
Anderson, G. K.:  The Importance of Protein in Diet Therapy , J. Am. Dietet. A. 21:436-439 ( (July-Aug.) ) 1945;.
Guggenheim, K., and Buechler, E.:  Nutrition and Resistance to Infection, the Effect of Quantitative and Qualitative Protein Deficiency on the Bactericidal Properties and Phagocytic Activity of the Peritoneal Fluid of Rats , J. Immunol. 58: 133-139 ( (Feb.) ) 1948;.
Coburn, A. F., and Moore, L. V.:  Nutrition as a Conditioning Factor in the Rheumatic State , Am. J. Dis. Child. 65:744-756 ( (May) ) 1943;.
Pottenger, F. M., Jr., and Pottenger, F. M.:  Adequate Diet in Tuberculosis , Am. Rev. Tuberc. 54:213-218 ( (Sept.) ) 1946;.
Duncan, A. C.:  Diet and Disease in the Subarctic , Lancet 2:919-921 ( (Dec. 20) ) 1947;.
McCance, R. A.; Widdowson, E. M., and Lehmann, H.:  The Effect of Protein Intake on the Absorption of Calcium and Magnesium , Biochem. J. 36:686-691, 1942;.
Shourie, K. L.:  Dental Caries in Indian Children , Indian J. M. Research 29:709 ( (Oct.) ) 1941;.
Elvehjem, C. A.:  A Nutritionist's View of the Caries Problem , J. Am. Dent A. 37:410-415 ( (Oct.) ) 1948;.
Waugh, L. M.:  I. A Study of the Nutrition and Teeth of the Eskimo of North Bering Sea and Arctic Alaska , J. Dent. Research 10:387 ( (June) ) 1930;
 II. A Study of the Nutrition and Teeth of the Eskimo of North Bering and Arctic Alaska , WaughJ. Dent. Research 11:453 ( (June) ) 1931;
 III. Nutrition and Health of the Labrador Eskimo, With Special Reference to the Mouth and Teeth , WaughJ. Dent. Research 8: 428 ( (June) ) 1928;
Elvehjem, C. A.:  A Nutritionist's View of the Caries Problem , J. Am. Dent. A. 37: 410-415 ( (Oct.) ) 1948;.
Himsworth, H. P.:  Protein Metabolism in Relation to Disease, Presidential Address in the Section of Experimental Medicine and Therapeutics of the Royal Society of Medicine; abstracted , Brit. M. J. 2: 662-663 ( (Nov. 2) ) 1946;.
Graham, J. R., and Scott, T. M.:  Notes on the Treatment of Tetanus , New England J. Med. 235: 846-852 ( (Dec. 12) ) 1946;.
Weech, A. A.; Wollstein, M., and Goettsch, E.:  Nutrition Edema in the Dog; V. Development of Deficits in Erythrocytes and Hemoglobin on a Diet Deficient in Protein , J. Clin. Investigation 16:719-728 ( (Sept.) ) 1937;.
Orten, A. U., and Orten, J. M.:  The Role of Dietary Protein in Hemoglobin Formation , J. Nutrition 26:21-31 ( (July) ) 1943;.
Stare, F. J., and Thorn, G. W.:  Council on Foods and Nutrition, Protein Nutrition in Problems of Medical Interest , J. A. M. A. 127: 1120-1127 ( (April 28) ) 1945;.
Darby, W. J.:  Iron and Copper , J. A. M. A. 142: 1288-1295 ( (April 22) ) 1950;.
Bowes, A. deP., and Church, C. F.: Food Values of Portions Commonly Used , ed. 6, 1946;. (Available from Anna dePlanter Bowes, 311 S. Juniper St., Philadelphia 7, Pa.)
Food and Nutrition Board, National Research Council: Recommended Dietary Allowances, Revised 1948, Reprint and Circular Series No. 129 (Oct.) 1948.
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