All are seen in Marasmus except –

Hepatomegaly is seen in kwashiorkor (not in marasmus). Marasmus It is characterized by gross wasting of muscle and subcutaneous tissues resulting in emaciation and marked stunting. There is no oedema. Body weight is less than 60% expected. Fat in adipose tissues is severely depleted. However, the buccal pad of fat is preserved until the malnutrition becomes extreme because a higher proportion of saturated fatty acids is stored there and the saturated fat is the last to be depleted. Skin is dry, scaly and inelastic with wrinkles. The hair is hypopigmented. The abdomen is distended due to wasting and hypotonia of abdominal wall muscles. The child is alert but irritable. The child may show voracious appetite.