Although both kwashiorkor and marasmus occur due to protein calorie deficiency, there are some differences between the two.
Kwashiorkor seldom occurs before the age of 6 months when the child is either breastfed or bottle-fed, but marasmus is found even in very young babies when they do not get enough milk.
The marasmic child suffers from fluid and electrolyte loss and muscle atrophy, whereas the child suffering from kwashiorkor may have excessive fluid retention in the intracellular spaces producing oedema.
The marasmic child’s hair is dull and dry but not discoloured as in the case of kwashiorkor.
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The skin of the marasmic child is thin, wrinkled and has lost its elasticity whereas in the case of kwashiorkor pellagrous dermatitis (patchy skin lesions) is observed.
The marasmic child gives a staring look, whereas the kwashiorkor child will not.
In marasmus the gross wasting of the tissues result in a more extensive impairment of biological functions than in kwashiorkor.
In marasmus the face is shrunk giving an appearance of a monkey, whereas in the case of kwashiorkor moon face is observed.
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A diagrammatic comparison of the symptoms observed in marasmus, marasmic kwashiorkor and kwashiorkor is shown in the above Figure. The density of the shading indicates the degree of prevalence of each of the symptoms listed on the left.