RESUMO
INTRODUCTION: "Free" serum iron has been associated with the development of edema in Kwashiorkor-type severe acute malnutrition. MATERIAL AND METHODS: A descriptive, cross sectional study was performed. Twenty-four children with edematous malnutrition, 22 with marasmus and 20 without malnutrition were compared. "Free" iron, transferrin, saturation index and attachment capacity of iron, ferritin, total protein, albumin, total iron, and C-reactive protein (CRP) were determined in serum. RESULTS: A significant difference was found between malnourished children with "free" serum iron and the control group in which "free" iron was not found. However, no significant differences were found in "free" serum iron levels between marasmatic and edematous children. Transferrin was negatively correlated with "free" iron (r=-0.519; p=0.000). Total proteins, albumin and transferrin were all significantly lower in children with edema than in those with marasmus. A low transferrin level and a high saturation index could be used to estimate the probability of edema in 67.5% of cases (p=0.001). CONCLUSIONS: Severe acute malnutrition was associated with the presence of "free" serum iron both in children with marasmus and in those with edema. "Free" iron does not explain the presence of edema but, as with severe hypoalbuminemia, the concurrence of a low transferrin level and a high saturation index may contribute to the etiology of edema.