Kwashiorkor, with typical edema and skin rash is occasionally seen in affluent countries as a result of severe protein restriction. Treatment is with a lactose-free formula after rehydration and sometimes after a period of parenteral alimentation. Complications of therapy included: diarrhea, congestive heart failure, infections, a bleeding tendency, and seizures. Two of the 14 children in this series died.
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Chase et al. (1980) studied this question.