A 3-year-old child is brought to a nutrition rehabilitation centre with severe bilateral pitting oedema up to the knees, a moon face, sparse reddish-brown hair that plucks out easily, and a miserable, apathetic expression. Weight-for-height Z-score is -2.5. What is the most likely diagnosis?

• A Kwashiorkor ✓
• B Marasmus
• C Marasmic-kwashiorkor
• D Nutritional marasmus with vitamin A deficiency

Explanation

Kwashiorkor is protein-energy malnutrition predominantly due to protein deficiency. The hallmark features are bilateral pitting oedema, psychomotor changes (apathy, irritability), skin lesions (flaky paint dermatosis), hair changes (flag sign, depigmentation), and a pot belly. It classically presents in a child weaned abruptly onto a high-carbohydrate, low-protein diet. Marasmus presents with severe wasting ('skin and bones') but WITHOUT oedema.

Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.