A child weighing 6.2 kg is presented at 18 months of age. His weight-for-height Z-score is -3.2 (severe wasting). He has bilateral pitting pedal edema. As per WHO/IMNCI guidelines, this child has:

• A Severe acute malnutrition — Kwashiorkor type
• B Severe acute malnutrition — Marasmic Kwashiorkor ✓
• C Severe acute malnutrition — Marasmus type
• D Moderate acute malnutrition with incidental edema

Explanation

Marasmic Kwashiorkor is characterized by BOTH severe wasting (weight-for-height Z-score < -3 SD, or MUAC <115 mm) AND bilateral edema. Marasmus (SAM without edema) is purely energy deficiency causing severe wasting without edema. Kwashiorkor (SAM with edema but NOT severe wasting) is predominantly protein deficiency. Marasmic Kwashiorkor has the worst prognosis among the three. Bilateral pedal edema in SAM is a danger sign requiring inpatient management at an NRC (Nutrition Rehabilitation Centre).

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.