A 3-year-old child has oedema of both feet, skin lesions (flaky-paint dermatosis), and sparse, reddish-brown hair. His weight-for-height Z-score is -1.5. The diagnosis and the key pathophysiological mechanism is:

• A Kwashiorkor — hypoalbuminaemia leading to reduced colloid osmotic pressure causing oedema ✓
• B Marasmus — severe caloric deficit with preserved albumin causing paradoxical oedema
• C Marasmic kwashiorkor — both protein and energy deficit with normal albumin
• D Nutritional oedema from thiamine deficiency (wet beriberi)

Explanation

Kwashiorkor is characterised by protein-energy malnutrition with predominant protein deficiency. The classic triad includes oedema (bilateral pedal, progressing to generalised), skin changes (flaky-paint/crazy-paving dermatosis), and hair changes (sparse, discoloured, easily plucked). The oedema is due to hypoalbuminaemia reducing colloid osmotic pressure. Weight-for-height may be normal or near-normal because oedema masks wasting. Wet beriberi causes cardiac oedema, not with skin/hair changes.

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.