Case file 18: Marasmus

ESS tests are OVER and done with! OK back to BIO =) (diff font colour!!!!)


Today, lets talk about Marasmus. Marasmus is a form of severe protein-energy malnutrion, something like Kwashiorkor, caused mostly by prolonged calorie deficiency and energy deficiency. BUT, don't go start bingeing yet, because, Marasum occurrence increases prior to age 1 - which i doubt u are, if u are reading this blog. Marasmus, together with Kwashiorkkor and marasmic KW represent a group of pathologic conditions associated with a nutritional and energy deficit occuring mainly in young children from develping countries.


Infants suffering from Marasmus usually have a shrunken wasted appearance - dry skin, loose skin folds hanging over the glutei (simply put, ur BUTT muscles ), axillae (underams haha), etc. Drastic loss of adipose tissue from normal areas of fat deposits like buttocks and thighs. The afflicted are often fretful, irritable, and voraciously hungry. There may be alternate bands of pigmented and depigmented hair (flag sign), or flaky paint appearnace of skin due to peeling. Chronic diarrhea is also a frequent symptom.


Marasmus can also cause the amount of fat in the body to be severely decreased. In fact fat stores can be decreased to as low as 5% of the total body weight. And this remaining fat is usually stored in the liver (insulation??) so not much of it can actually be seen. In serious cases, the protein mass can decrease up to 30% (protein mass is usually found in the muscle and some organs). Organs that are affected primarily first are the - liver, heart, pancreas, and digestive tract.


The loss in weight and muscle mass because of Marasmus will inadvertly result in decrease in energy expenditure - impairing the response of sufferers to changes in the temperature, increasing risks of hypothermia


To diagnose Marasums, doctors may conduct physical examintation and a health histroy that probes eating habits and weight changes and assess the nutritional status. Nutritional status can be derived by comparing heigha nd weight to standardised norms, calculating BMI and measuring skindfold thickness or the circumference of the upper arm. A good nutritional and balanced diet in the long run is the only way to treat and prevent Marasmus. But in severe cases, three stages of treatment may be needed:

1. correcting fluid and electrolyte imbalances, treating infection with anti biotics that don't affect protein synthesis and addressing related medical problems.
2. replenishing essential nutrients slowly to prevent taxing the patient's weakened system by too much food
3. physical therapy may be beneficial to patients whose muscles have deteriorated significantly.


Marasmus is very common in less developed countries because of the poverty. Thus, many people cannot afford proper medical healthcare, or even the food. In all honesty, this has been one of the saddest diseases i have researched on so far. The children do not deserve this, and we should do something to help, even if its only on a monetary basis. (oops, did i go off topic?? sry!! )
marasmus in a 3 mth old baby.

prof. chia