Intravenous amino acids, cholestasis and kwashiorkor

Kwashiorkor dermatosis has not been reported in children on parenteral nutrition (PN). We report a case of kwashiorkor developing in a partially PN dependent patient with cholestasis, when amino acids were removed from the PN solution in an effort to control the cholestasis. Although the kwashiorkor dermatosis improved within 24 hours after the addition of amino acids (1 g/kg) to the PN solution, the cholestasis worsened.