Marasmus

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Summary of Marasmus

Marasmus is a form of severe malnutrition characterized by energy deficiency. A child with marasmus looks emaciated. Body weight is reduced to less than 60% of the normal (expected) body weight for the age. Marasmus usually occurs during the first year of life, whereas kwashiorkor occurrence increases after 18 months. Marasmus 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. Protein wasting in kwashiorkor or marasmus may lead to edema.

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Marasmus

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Marasmus

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An 11-month-old refugee infant boy is brought to the pediatrician's office for a routine medical examination. His medical history is relevant to low-height and growth below the third percentile since birth. On physical examination, the patient has a cachectic appearance. Evaluation of muscle mass shows a significant loss of subcutaneous fat, dry skin, and "broomstick" extremities. His temperature is 36.4°C (97.5°F), pulse is 100/min, respirations are 17/min, blood pressure is 110/60 mmHg. His current BMI is 13. Which of the following abnormalities is the most likely cause of these findings?

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