Marasmus is a form of severe malnutrition characterized by energy deficiency. 

It usually occurs in children.



Body weight is reduced to less than 62% of the expected body weight for the age.



In dry climates, marasmus is  more frequent disease than kwashiorkor,  associated with malnutrition. 



Marasmus occurrence increases prior to age 1, whereas kwashiorkor occurrence increases after 18 months. 



 Kwashiorkor is protein deficiency with adequate energy intake whereas marasmus is inadequate energy intake in all forms, including protein. 



This clear-cut separation of marasmus and kwashiorkor is not always clinically evident: mixed clinical pictures, called marasmic kwashiorkor, are possible. 



Protein wasting in kwashiorkor generally leads to edema and ascites.



Muscular wasting and loss of subcutaneous fat are the main clinical signs of marasmus.



Marasmus’prognosis is better than it is for kwashiorkor.



Half of severely malnourished children die due to unavailability of adequate treatment.



Edema is not a sign of marasmus and is present in only kwashiorkor and marasmic kwashiorkor. 



Symptoms of marasmus include:  hypothermia, pyrexia, anemia, dehydration, hypovolemic shock, cold extremities; decreased consciousness, tachypnea, pneumonia, heart failure, abdominal distention, decreased bowel sounds; large or small liver; blood or mucus in the stools. ocular manifestations with corneal lesions associated with vitamin A deficiency, 


dermal manifestations with evidence of infection, purpura, ear, nose, and throat symptoms, dry skin and brittle hair.



Marasmus can also make children short-tempered and irritable.




Marasmus is caused by:



Maternal malnutrition



Maternal anemia






Pathological conditions in a baby such as chronic diarrhea.






Cyanotic heart diseases





Necrotizing enterocolitis



Pyloric stenosis



Lactose intolerance









Anorexia nervosa



Treatment consists of managing the causes and complications of the disorder: infections, dehydration, and circulation disorders.



Management, initially, is feeding the child dried skim milk that has been mixed with boiled water. 



Subsequently, a vegetable mix can be added including sesame, casein, and sugar.



Refeeding is done slowly to avoid refeeding syndrome. 



Infections are commonly present in children with marasmus and antibiotics are  commonly used.



In 2016, the prevalence of marasmus in the United States was 0.5%. 



Its  prevalence is higher in hospitalized children, especially ones with chronic illnesses.



Approximately 50 million children less than 5 years old who have protein-energy malnutrition: 80% live in Asia, 15% in Africa, and 5% in Latin America. 



It is estimated that the prevalence of acute malnutrition in Germany, France, the United Kingdom, and the United States to be 6.1–14%. 



In Turkey, the prevalence of Acute malnutrition is as high as 32%.



There is no evident racial predisposition that correlates to malnutrition. 



A strong association of malnutrition and  geographic distribution of poverty exists.



Marasmus is more commonly seen in children under the age of 5 due to increased in energy need and susceptibility to viral and bacterial infections.



The elderly as another population that is vulnerable to malnutrition. 







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