RT Book, Section A1 Langston, Shannon M. A1 Bales, Brian D. A2 Knoop, Kevin J. A2 Stack, Lawrence B. A2 Storrow, Alan B. A2 Thurman, R. Jason SR Print(0) ID 1181051461 T1 Protein-Energy Malnutrition—Kwashiorkor and Marasmus T2 The Atlas of Emergency Medicine, 5e YR 2021 FD 2021 PB McGraw-Hill PP New York, NY SN 9781260134940 LK accessemergencymedicine.mhmedical.com/content.aspx?aid=1181051461 RD 2024/03/28 AB Protein-energy malnutrition (PEM) applies to a group of disorders including kwashiorkor and marasmus. These are characterized by an imbalance between the body’s supply and demand of energy and nutrients. Kwashiorkor means “the sickness of weaning” as it is often seen following weaning after birth. It usually occurs between the ages of 1 and 4 with a deficiency of dietary protein in the presence of normal to high carbohydrate intake. The etiology is complex, but there is decreased synthesis of proteins resulting in hypoalbuminemia. Kwashiorkor is an acute illness manifested by edema secondary to fluid and sodium retention. Patients have peripheral edema, anasarca, moon facies, apathy, and a protuberant abdomen secondary to hepatomegaly. The skin can become hyperkeratotic and may split open in pressure-prone areas.