E40-E46 Malnutrition

 
Chapter IV

Endocrine, nutritional and metabolic diseases
(E00-E90)

Malnutrition
(E40-E46)

Note:
The degree of malnutrition is usually measured in terms of weight, expressed in standard deviations from the mean of the relevant reference population. When one or more previous measurements are available, lack of weight gain in children, or evidence of weight loss in children or adults, is usually indicative of malnutrition. When only one measurement is available, the diagnosis is based on probabilities and is not definitive without other clinical or laboratory tests. In the exceptional circumstances that no measurement of weight is available, reliance should be placed on clinical evidence.

If an observed weight is below the mean value of the reference population, there is a high probability of severe malnutrition if there is an observed value situated 3 or more standard deviations below the mean value of the reference population; a high probability of moderate malnutrition for an observed value located between 2 and less than 3 standard deviations below this mean; and a high probability of mild malnutrition for an observed value located between 1 and less than 2 standard deviations below this mean.

Excludes:
* intestinal malabsorption (K90.-)
* nutritional anaemias (D50-D53)
* sequelae of protein-energy malnutrition (E64.0)
* slim disease (B22.2)
* starvation (T73.0)

E40		Kwashiorkor Latin: Morbus kwashiorkor
		Severe malnutrition with nutritional oedema with dyspigmentation of skin and hair.
		Excludes:	marasmic kwashiorkor (E42)

E41		Nutritional marasmus Latin: Marasmus malnutritionalis
		Severe malnutrition with marasmus
		Excludes:	marasmic kwashiorkor (E42)

E42		Marasmic kwashiorkor Latin: Kwashiorkor marasmaticus
		Severe protein-energy malnutrition [as in E43]: · intermediate form · with signs of both kwashiorkor and marasmus

E43		Unspecified severe protein-energy malnutrition Latin: Malnutritio proteinoenergetica gravis, non specificata
		Severe loss of weight [wasting] in children or adults, or lack of weight gain in children leading to an observed weight that is at least 3 standard deviations below the mean value for the reference population (or a similar loss expressed through other statistical approaches). When only one measurement is available, there is a high probability of severe wasting when the observed weight is 3 or more standard deviations below the mean of the reference population.
		Starvation oedema

E44		Protein-energy malnutrition of moderate and mild degree Latin: Malnutritio proteinoenergetica mitis et moderate gravis
E44.0		Moderate protein-energy malnutrition Latin: Malnutritio moderata
		Weight loss in children or adults, or lack of weight gain in children leading to an observed weight that is 2 or more but less than 3 standard deviations below the mean value for the reference population (or a similar loss expressed through other statistical approaches). When only one measurement is available, there is a high probability of moderate protein-energy malnutrition when the observed weight is 2 or more but less than 3 standard deviations below the mean of the reference population.
E44.1		Mild protein-energy malnutrition Latin: Malnutritio proteinoenergetica mitis
		Weight loss in children or adults, or lack of weight gain in children leading to an observed weight that is 1 or more but less than 2 standard deviations below the mean value for the reference population (or a similar loss expresssed through other statistical approaches). When only one measurement is available, there is a high probability of mild protein-energy malnutrition when the observed weight is 1 or more but less than 2 standard deviations below the mean of the reference population.

E45		Retarded development following protein-energy malnutrition Latin: Retardatio propter malnutritionem proteinoenergeticam
		Nutritional: · short stature · stunting Physical retardation due to malnutrition

E46		Unspecified protein-energy malnutrition Latin: Malnutritio proteinoenergeticam, non specificata
		Malnutrition NOS Protein-energy imbalance NOS

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