A 3-year-old child presents with bilateral pitting pedal oedema, hepatomegaly, sparse hair with flag sign, and preserved subcutaneous fat. Serum albumin is 18 g/L. The MOST likely diagnosis is:

• A Kwashiorkor ✓
• B Marasmus
• C Marasmic kwashiorkor
• D Vitamin A deficiency

Explanation

Kwashiorkor is protein deficiency with relatively adequate calories, producing hypoalbuminaemia, oedema, fatty liver, and flag sign while subcutaneous fat is comparatively preserved. Marasmus is combined calorie and protein deficiency where weight loss and loss of subcutaneous fat dominate and oedema is absent, which kills option B. Marasmic kwashiorkor combines severe wasting with oedema, but this child has preserved fat stores pointing to pure kwashiorkor.

Reference: Nelson Textbook of Pediatrics, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.