Marasmus vs. Kwashiorkor: Clinical Features, Comparison, and Management

A set of vocabulary flashcards detailing the differences, clinical signs, parameters, treatment steps, and prevention of Kwashiorkor and Marasmus.

Kwashiorkor

A form of malnutrition caused by a severe lack of protein (low protein intake) essential in pregnancy and early childhood development, characterized by irritability, edema, protruding abdomen, moonface, diarrhea, and orange hair.

Marasmus

A condition characterized by severe loss of muscle mass and fat due to low calorie intake, poverty, scarcity of food, premature birth, or a baby failing to latch, leading to lethargy, severe growth retardation, a shrunken abdomen, and an old man's face.

Moonface (Kwashiorkor)

The characteristic facial appearance seen in Kwashiorkor caused by swelling and edema.

Old man's face (Marasmus)

The characteristic facial appearance seen in Marasmus resulting from severe wasting and loss of muscle mass and subcutaneous fat.

Age of onset (Kwashiorkor vs. Marasmus)

Kwashiorkor typically presents in pre-school children ($1\text{--}5\text{ years old}$), whereas Marasmus typically presents in weaned infants ($< 1\text{ year old}$).

Main nutritional cause (Kwashiorkor vs. Marasmus)

Kwashiorkor is primarily caused by low protein intake, while Marasmus is caused by low calorie intake.

Body weight parameter (Kwashiorkor vs. Marasmus)

Body weight is $60\text{--}80\text{\%}$ of normal in Kwashiorkor, compared to $< 60\text{\%}$ of normal in Marasmus.

Growth retardation (Kwashiorkor vs. Marasmus)

Growth shows mild retardation in Kwashiorkor, whereas it exhibits severe retardation in Marasmus.

Abdominal appearance (Kwashiorkor vs. Marasmus)

The abdomen is protruding (bulging) in Kwashiorkor due to edema, whereas it is shrunken in Marasmus.

Behavioral symptoms (Kwashiorkor vs. Marasmus)

A child with Kwashiorkor is very irritable, whereas a child with Marasmus is very lethargic.

Clinical signs of Kwashiorkor

Weight loss, edema and swelling of hands and feet, dehydration, stomach bulging, diarrhea, and orange hair occurring in young children and babies.

Clinical signs of Marasmus

Inability to grow or gain weight, loss of muscle mass and fat, stomach shrinkage, and anemia occurring in weaning babies.

Initial treatment priority

The clinical protocol of treating underlying deficiencies and viruses first before advancing nutritional feeds.

Refeeding formula

Skimmed milk formula prepared with snaitised water, with its energy content increased by the addition of sunflower oil.

Dietary progression to solids

The nutritional step following milk formula feeds, consisting of solids of cereals and mince.

Feed advancement rate

The treatment guideline stating that the more severe cases require feeds to be increased more slowly.

Long-term prognosis and recurrence

Even if treated, improper physical and mental develop may still occur, and reoccurrence is high unless living conditions are drastically improved.

Prevention of severe malnutrition

Measures including an adequate and varied diet along with public education.