Marasmus vs Kwashiorkor
How to tell Marasmus and Kwashiorkor apart when a board question makes them look alike.
Marasmus is total calorie wasting without edema; kwashiorkor is protein deficiency with edema and fatty liver.
Side by side
Marasmus is total calorie deficiency causing severe wasting, loss of subcutaneous fat and muscle, stunted growth, and no prominent edema.
Kwashiorkor is protein deficiency with relatively preserved calories causing edema, fatty liver, flaky paint dermatitis, hair depigmentation, and apathy.
Global energy deficiency drives catabolism of fat and muscle to maintain essential metabolism.
Low protein intake reduces albumin and apolipoprotein synthesis, causing edema and hepatic fat accumulation.
Severe wasting, low weight-for-height, and absent edema support marasmus.
Edema, hypoalbuminemia, fatty liver, skin/hair changes, and apathy support kwashiorkor.
The trap
Both are protein-energy malnutrition, but edema and fatty liver are the fast kwashiorkor clues.
Watch it explained
Test it nowThe repair move
For malnutrition, ask whether edema and fatty liver are present before naming the syndrome.
Try a free question
CoreA 14-month-old child in a refugee camp has weight 60% of expected for age, marked muscle and subcutaneous fat wasting, sunken cheeks, growth retardation, and a wizened 'old man' appearance. There is NO edema and NO hepatomegaly. Hair and skin appear normal. Which form of severe malnutrition is most likely?
Show answer and explanation
Answer: A. Marasmus (total calorie deficiency). Marasmus is total calorie deficiency with severe wasting of fat and muscle, growth retardation, and a wizened appearance. Edema is ABSENT because protein and oncotic pressure are relatively preserved.
Why the other choices are tempting
- B. Kwashiorkor has pitting edema, hepatomegaly with fatty liver, hypoalbuminemia, and skin and hair changes, not pure wasting without edema.
- C. Marasmic kwashiorkor is a mixed picture with both severe wasting and edema.
- D. Anorexia nervosa is a psychiatric disorder in older patients, not infants in refugee camps.
- E. Wilson disease causes hepatic and neurologic disease from copper accumulation, not severe malnutrition wasting.
Flashcards
Tap a card to flip it.
What clue supports Marasmus?
Choose Marasmus when the stem gives this pattern: Marasmus is total calorie deficiency causing severe wasting, loss of subcutaneous fat and muscle, stunted growth, and no prominent edema.
What clue supports Kwashiorkor?
Choose Kwashiorkor when the stem gives this contrasting pattern: Kwashiorkor is protein deficiency with relatively preserved calories causing edema, fatty liver, flaky paint dermatitis, hair depigmentation, and apathy.
Quick answers
What is the fastest way to tell Marasmus from Kwashiorkor?
Marasmus is total calorie wasting without edema; kwashiorkor is protein deficiency with edema and fatty liver.
What is the key clue for Marasmus?
Marasmus is total calorie deficiency causing severe wasting, loss of subcutaneous fat and muscle, stunted growth, and no prominent edema.
What is the key clue for Kwashiorkor?
Kwashiorkor is protein deficiency with relatively preserved calories causing edema, fatty liver, flaky paint dermatitis, hair depigmentation, and apathy.
What is the common trap with Marasmus vs Kwashiorkor?
Both are protein-energy malnutrition, but edema and fatty liver are the fast kwashiorkor clues.