Nutritional Disorders: Protein Malnutrition

• Kwashiorkor is characterized by malnutrition with severe protein depletion.
• Marasmus refers to malnutrition from generalized calorie deficiency.

The loss of plasma oncotic pressure leads to peripheral edema, which, to some extent masks the visceral wasting, and is associated with:

• Protuberant belly
• Edematous feet
• Fatty liver from loss of apolipoprotein synthesis
• "Flaky paint" skin appearance so named because it alternates between hyper- to hypo- pigmentation
• Shiny skin and alopecia

Pure wasting, Growth retardation, and Anemia. Marasmus patients have an emaciated appearance rather than a swollen appearance because it is typified by a loss of body fat and muscle whereas kwashiorkor results in a loss in plasma oncotic pressure, which produces signs of swelling from edema.