# Kwashiorkor and Marasmus

**Summary**  
Kwashiorkor and Marasmus are diseases of severe malnutrition, which are rare in developed countries but sometimes observed in developing countries. Kwashiorkor is a disease caused by protein deficiency, presenting with swelling of the belly (secondary to edema), skin lesions, fatty change of the liver, and anemia. Marasmus describes generalized muscle wasting caused by a deficiency of all nutrients, or a total caloric deficiency. It can be seen in people with poor intake, although cancer-related muscle wasting may also be described as marasmus.

**Key Points**  
- **Kwashiorkor**  
  - Also known as “edematous malnutrition”  
  - Caused by **protein deficiency**  
  - Classically presents in children with:  
    - **swollen edematous belly**  
      - low plasma oncotic pressure secondary to decreased albumin  
    - fatty liver disease  
      - thought to be secondary to decreased apolipoproteins  
    - skin lesions (e.g. hyperkeratosis, dyspigmentation)  
    - anemia  
      - thought to be secondary to reduced globin proteins  
- **Marasmus**  
  - From Latin _marasmos_ (wasting away/withering)  
  - Caused by **total caloric deficiency**  
  - Symptoms include generalized **muscle wasting**

Find Kwashiorkor, Marasmus, and other Nutrition topics among Pixorize's visual mnemonics for the USMLE Step 1 and NBME Shelf Exams.