Taheri S*, Surak A, Bravo G, McMurray A and Altamirano-Diaz L
Abstract Introduction: Kwashiorkor is a type of protein-calorie malnutrition often seen in children of impoverished countries and famine. It is a result of insufficient protein intake in the context of adequate caloric intake. Case report: We report a case of a 13-year-old male with trisomy 21 in Southwestern Ontario, Canada who presented with bilateral pneumonia, pericardial effusion and peripheral edema. Evaluation revealed severe dietary restriction, consistent with kwashiorkor. Child was placed on severely restrictive diet, particularly limiting dairy intake to one daily cup of plain, unfortified yogurt. His hospital course was complicated with severe hypocalcemia, hypomagnesemia and hypophosphatemia. These findings resolved gradually upon slow introduction of well-balanced diet and adequate caloric and protein intake. Conclusion: Malnutrition is often underdiagnosed or misdiagnosed in developed countries with devastating outcomes if unrecognized. This makes it imperative to consider this diagnosis, recognize potential risk factors and be prepared to accurately assess overall nutritional status