In simple words: Marasmic kwashiorkor is a severe form of malnutrition affecting young children, showing symptoms of both marasmus (severe wasting) and kwashiorkor (swelling due to lack of protein). It is caused by a severe lack of protein and calories in the diet. Symptoms can include a swollen belly, muscle loss, swelling all over the body, dehydration, severe anemia, dry skin, changes in hair color, an enlarged liver, infections, and stunted growth. If not treated, it can lead to permanent disabilities, coma, or even death.

Marasmic kwashiorkor is a severe type of protein-calorie malnutrition mainly occurring in infants and young children between one and three years of age. This type of malnutrition shows symptoms of both marasmus and kwashiorkor. Marasmic kwashiorkor occurs primarily in developing countries and poverty-stricken areas due to severe protein deficiency immediately after weaning, lack of nutritional diet, parasites and infections, child abuse or severe neglect, and inadequate healthy food habits. Patients with marasmic kwashiorkor may exhibit a protuberant belly, muscle wasting, generalized edema, dehydration, severe anemia, skin dryness, changes in hair color, enlarged fatty liver, infection, and growth retardation. If left untreated, it may lead to permanent physical or mental disability, coma, and death. Providers diagnose the condition based on the patient’s history, signs and symptoms, and physical examination. Laboratory tests include blood and urine tests to measure protein and blood glucose. Imaging tests include ultrasound of the abdomen to detect liver enlargement; other tests include calculation of BMI (body mass index), skin biopsy, and hair analysis. Treatment depends on symptom severity and may include a protein-rich diet and vitamin supplements; severe cases need hospitalization to treat dehydration, low blood glucose, anemia, and infection. Severe anemia is treated with blood transfusions, and an infection is treated with antibiotics.

Example 1: A 2-year-old child from a developing country presents with a distended abdomen, muscle wasting, edema, and dry skin. Blood tests reveal severe anemia and hypoglycemia. The child is diagnosed with marasmic kwashiorkor., An 18-month-old child exhibits stunted growth, changes in hair color, and skin lesions. Upon examination, the physician notes edema and hepatomegaly. The child's diet history reveals severe protein deficiency, leading to a diagnosis of marasmic kwashiorkor., A neglected 3-year-old child presents with severe dehydration, infection, and altered mental status. Physical examination reveals muscle wasting and edema. The child's condition is diagnosed as marasmic kwashiorkor secondary to severe neglect.

Documentation should include the patient's history, dietary habits, physical examination findings (e.g., edema, muscle wasting, skin changes, abdominal distension), laboratory results (blood and urine tests, blood glucose levels), imaging results (ultrasound), BMI, and any other relevant diagnostic findings (skin biopsy, hair analysis).