Overview and Treatment Protein-calorie malnutrition results in 2
similar but distinct diseases, marasmus and kwashiorkor.
Marasmus is defined simply as chronic deprivation of energy
needed to maintain body weight. Its extreme form is
characterized by severe weight loss and cachexia.1 Marasmus is
further characterized by subnormal body temperature, decreased
pulse and metabolic rate, loss of skin turgor, constipation, and
starvation diarrhea, consisting of frequent, small, mucus-
containing stools.2 Kwashiorkor is a somewhat more complex
disease. It is characterized by edema, low capillary-filtration
rate, hypoalbuminemia, and dermatitis. Derived from an African
term meaning "the disease that occurs when the next baby is
born", kwashiorkor was initially thought to result from a diet
high in calories (mainly carbohydrates, such as maize), yet
deficient in protein. However, infection, aflatoxin poisoning,
and oxidative stress may also play causative roles.1,3 Edema, a
defining characteristic of kwashiorkor, resol