Marasmus and Marasmic Kwashiorkor

Marasmus:

Child reacts to the stress of PEM and secretes cortisol, which mobilises protein from muscle and subcutaneous tissue to amino acid pool resulting in wasting with no oedema and no hepatomegaly.Raised cortisol level lowers growth hormone and so the child is stunted.Marasmus is said to be well adapted to the stress of deficit in protein and calories.The signs and symptoms observed in marasmic child are the following :

• Severe growth retardation

• Loss of subcutaneous fat

• Severe muscle wasting

• The child looks appallingly thin and limbs appear as skin and bones

• Shrivelled body

• Wrinkled skin

• Bony prominence

• Associated vitamin deficiencies

• Failure to thrive

• Irritability, fretfulness and apathy

• Frequent watery diarrhoea and acid stools

• Mostly hungry but some are anorectic

• Dehydration

• Temperature is subnormal

• Muscles are weak

• Oedema and fatty infiltration are absent

Marasmic Kwashiorkor:

The child shows a mixture of some of the features of marasmus and kwashiorkor. This is due to the varying nature of the dietary deficiency and the social factors responsible for the disease and presence or absence of infections.

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Nutrition Science by B. Srilakshmi

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