Difference Between Kwashiorkor and Marasmus

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What is the Difference Between Kwashiorkor and Marasmus?

For our body to function normally, it requires some basic nutrients, calories and proteins without which the body fails to function as it has to. Due to the lack of nutrients in the body, the muscles and bones start to weaken. This lack of proper nutrients in the body leads to malnutrition. Generally, malnutrition does not occur due to short-term illnesses like fever, cough, and cold occurring at some point in time. The body tends to become malnourished if it has refrained from necessary nutrition for a long duration of time.


Even if the person is taking enough quantity of food, sometimes the food lacks quality or the food lacks proper nutrient value. Some underlying conditions are also responsible for the improper absorption of nutrients in the body.


Kwashiorkor

This is a type of malnutrition due to the deficiency of protein. Generally, it is characterized by enlargement of the liver and edema. There is a difference between proper calorie intake and protein consumption. The patient, in this case, has proper calorie intake but lacks proper protein consumption. Kwashiorkor cases are usually food in places where there is scarcity in food supply like underdeveloped or developing countries. Kwashiorkor term was first introduced by a Jamaican paediatrician named Cicely Williams in the year 1935. This condition was first noticed in children who were weaned from breast milk quite early due to the birth of the younger siblings. Breast milk is the powerhouse of amino acids which is crucial for the proper nourishment and growth of infants. The risk of developing Kwashiorkor increases when the infant lacks the intake of these amino acids and is subjected to a diet that is high in carbohydrates like maize quite early in their life.


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Pathology

When there is a severe lack of protein in the body, there is an osmotic imbalance in the gastro-intestinal system leading to swelling in the gut which is later characterized as retention of water or edema. Extreme fluid retention is noticed in patients in whom the lymphatic system has irregularities. Proper functioning of the lymphatic system is necessary for proper lipid absorption and immunity. The lymphatic system in patients suffering from Kwashiorkor fails to recover fluids leading to the failure of the immune system and ultimately there will be low lipid absorption. This leads to malnourishment.


Diagnosis and Treatment

Kwashiorkor is characterized by bilateral peripheral pitting edema due to fluid retention, abdominal distention, and low weight as per the height.

The treatment protocol includes rectifying the electrolyte imbalance, preventing infection, treating hypoglycemia. A diet rich in carbohydrates and sugar that is enriched in proteins as well as essential micronutrients is provided. Diet rich in lactases is introduced in children who have become lactose intolerant. Further milk is replaced with cereals rich in vitamins and minerals for the achievement of proper weight. Once the child reaches a normal weight, traditional food can be introduced in their meals.


Marasmus

Unlike Kwashiorkor, Marasmus is malnutrition that is characterized by a deficiency of energy. The child is malnourished due to insufficient energy intake in all forms which includes even proteins. This leads to 62% low body weight with respect to height and age. The chances of death increases in children who are not subjected to treatment early.


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Diagnosis and Treatment

The main clinical signs and symptoms include overall muscle wasting and loss of subcutaneous fat.

The first line of treatment includes prevention of dehydration, treatment of the infection, and circular disorders if any. Skim milk mixed with boiled water is introduced until the child becomes lactose tolerant. Later, a mix of vegetable is added to the diet and child should be subjected to a more balanced diet once they start to recover and gain back proper weight.


Difference Between Kwashiorkor and Marasmus

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Kwashiorkor

Marasmus

1

Occurs in children who have normal calorie intake but the diet is severely deficient in proteins.

Occurs in children who have an overall deficiency in energy intake which includes even proteins.

2

Characterized by bilateral peripheral pitting edema due to fluid retention and distended abdomen.

Characterized by severe muscle wasting and loss of subcutaneous fat in the whole body. 

3

Symptoms include thinning of hair, dermatitis, loss of teeth, and depigmentation of skin

Symptoms include dehydration, total muscle loss, anaemia, dry skin, and brittle hair, children are more irritable. 

4

Kwashiorkor susceptibility increases after 18 months of age.

Marasmus occurs before 1-year of age.

FAQ (Frequently Asked Questions)

1. List the Causes of Kwashiorkor and Marasmus.

Ans: Kwashiorkor - Main Causes Include:

  • Intake of a diet low in proteins.

  • Can also be caused due to infections that interfere with proper protein absorption in the body.

Marasmus - Main Causes Include:

  • Malnutrition of the mother.

  • Anaemia.

  • Poverty.

  • Pathological conditions in the child including diarrhoea, malaria, meningitis, lactose intolerance, etc.

2. What are the Symptoms of Kwashiorkor?

Ans: The symptoms of Kwashiorkor include:

  • The puffy appearance of the extremities due to water retention and swollen abdomen due to abdominal distention.

  • Low weight with respect to the height and age of the child and inability to gain weight.

  • Enlargement of the liver.

  • Depigmentation of the skin.

3. What are the Symptoms of Marasmus?

Ans: The symptoms of marasmus include:

  • Shrunken appearance.

  • Total loss of muscle mass and loss of subcutaneous fat making the appearance lean with protruding ribs.

  • Dehydration.

  • Unusual body temperature.

  • Decreased consciousness. 

  • Dry skin with thin and brittle hair.