MARASMUS
Marasmus is a form of severe malnutrition characterized by energy deficiency. It can occur in
anyone with severe malnutrition but usually occurs in children.[1] Body weight is reduced to less than
62% of the normal (expected) body weight for the age.[2] Marasmus occurrence increases prior to
age 1,
Marasmus is commonly represented by a shrunken, wasted appearance, loss of muscle mass and
subcutaneous fat mass.[6] Buttocks and upper limb muscle groups are usually more affected than
others. Other symptoms of marasmus include unusual body temperature (hypothermia,
pyrexia); anemia; dehydration (as characterized with consistent thirst and shrunken eyes);
hypovolemic shock (weak radial pulse; cold extremities; decreased consciousness); tachypnea
(pneumonia, heart failure); abdominal manifestations (distension, decreased or metallic bowel
sounds; large or small liver; blood or mucus in the stools), ocular manifestations (corneal lesions
associated with vitamin A deficiency); dermal manifestations (evidence of infection, purpura, and
ear, nose, and throat symptoms (otitis, rhinitis). Dry skin and brittle hair are also symptoms of
marasmus. Marasmus can also make children short-tempered and irritable
Marasmus is caused by the following factors:
Maternal malnutrition
Maternal anemia
Poverty
Pathological conditions in a baby (e.g., diarrhea)
Pneumonia
Cyanotic heart diseases
Malaria
Necrotizing enterocolitis
Pyloric stenosis
Lactose intolerance
Intussusception
Meningitis
Anorexia nervosa
Both the causes and complications of the disorder must be treated, including infections, dehydration,
and circulation disorders, which are frequently lethal and lead to high mortality if ignored. Initially, the
child is fed dried skim milk that has been mixed with boiled water. Once the child tolerates the milk, a
vegetable mix can be added including sesame, casein, and sugar.[7] Refeeding must be done slowly
to avoid refeeding syndrome. Once children start to recover, they should have more balanced diets
which meet their nutritional needs. Children with marasmus commonly develop infections and are
consequently treated with antibiotics or other medications.[8] Ultimately, marasmus can progress to
the point of no return when the body's ability for protein synthesis is lost. At this point, attempts to
correct the disorder by giving food or protein become futile, and death is inevitable.
Marasmus is more commonly seen in children under the age of five due to that age range being
characterized as one that has an increase in energy need and susceptibility to viral and bacterial
infections.[11] The World Health Organization also identifies the elderly as another population that is
vulnerable to malnutrition. Because their nutritional requirement is not well defined, attempts to
provide them with the necessary nutrition becomes difficult.
What are the external signs of marasmus?
Visible wasting of fat and muscle.
Prominent skeleton.
Head appears large for the body.
Face may appear old and wizened.
Dry, loose skin (skin atrophy).
Dry, brittle hair or hair loss.
Sunken fontanelles in infants.
Lethargy, apathy and weakness.
Weight loss of more than 40%.
BMI below 16.
in the global community, preventing marasmus means:
Fighting poverty.
Eliminating food deserts.
Improving nutritional education.
Controlling widespread infectious diseases.
Improving sanitation in developing countries.
Improving elder care in developed countries.
