Marasmus

What is it? Answer What causes it? Answer How many causes are there? Answer What are the risk factors? Answer What's normal? Answer How is it diagnosed? Answer What are the symptoms? Answer What are the signs? Answer What are the clinical findings? Answer What are the lab or investigation findings? Answer What is the treatment? Answer What are the workable treatment options? Answer How could this be prevented? Answer

Marasmus What is it? Marasmus is a form of severe malnutrition characterized by energy deficiency. It can occur in anyone with severe malnutrition but usually occurs in children. Body weight is reduced to less than 62% of the normal (expected) body weight for the age. Marasmus occurrence increases prior to age 1, whereas kwashiorkor occurrence increases after 18 months. It can be distinguished from kwashiorkor in that 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 however not always clinically evident as kwashiorkor is often seen in a context of insufficient caloric intake, and mixed clinical pictures, called marasmic kwashiorkor, are possible. Protein wasting in kwashiorkor generally leads to edema and ascites, while muscular wasting and loss of subcutaneous fat are the main clinical signs of marasmus, which makes the ribs and joints protrude. Both adults and children can have marasmus. Marasmus is one of the 3 forms of serious protein-energy malnutrition (PEM). The other 2 forms are kwashiorkor (KW) and marasmic KW. These forms of serious PEM represent a group of pathologic conditions associated with a nutritional and energy deficit occurring mainly in young children from developing countries at the time of weaning. What are the signs? Head appears large for the body. Visible wasting of fat and muscle. Prominent skeleton. Face may appear old and wizened. Dry, loose skin (skin atrophy). Dry, brittle hair or hair loss. Sunken fontanelles in infants. Lethargy, apathy and weakness. Weight loss of more than 40%. BMI below 16. Other symptoms and complications Dehydration. Electrolyte imbalances. Low blood pressure. Slow heart rate. Low body temperature. Gastrointestinal malabsorption. Stunted growth. Developmental delays. Anemia. Osteomalacia or rickets. What is the treatment? Initial treatment of marasmus often includes dried skim milk powder mixed with boiled water. Later, the mixture can also include a vegetable oil such as sesame, casein, and sugar. Casein is milk protein. The oil increases the energy content and density of the mixture. Once a child starts to recover, they should have a more balanced diet that meets their nutritional needs. If dehydration is a problem because of diarrhea, rehydration should also be a priority. A child may not necessarily need fluids delivered intravenously. Oral hydration may be sufficient. Infections are common among children with marasmus, so treatment with antibiotics or other medications is standard. Treating infections and any other health issues can help give them the best chance of recovery. How could this be prevented? With proper nutrition and medical care, the outlook can be a positive one. Relief workers can provide food and healthcare to regions where marasmus and other malnutrition problems are common. The best outcomes occur when a child’s parents or guardians know about the importance of nutrition and how to prepare foods properly. Healthy weight gain and growth can resume fairly quickly once a child with marasmus starts consuming more: calories protein carbohydrates other nutrients Last Updated: March 19, 2024