Understanding the Signs: Which of the following is a common symptom of kwashiorkor?

October 25, 2025 •

2 min read

According to the World Health Organization, protein-energy malnutrition, including kwashiorkor, is a significant global health issue, particularly in regions facing famine or food insecurity. The most distinguishing feature of this severe nutritional deficiency is edema. This article answers the crucial question: Which of the following is a common symptom of kwashiorkor?, by detailing the key physical and systemic indicators of this disease.

Quick Summary

Kwashiorkor is a severe form of malnutrition caused by a lack of protein in the diet. It is most distinctly characterized by fluid retention, leading to edema and a swollen abdomen, among other symptoms like skin and hair changes.

Key Points

Key Symptom: Edema: The most common and defining symptom of kwashiorkor is edema, a bilateral pitting swelling caused by fluid retention, often in the ankles, feet, and face.
Distended Abdomen: A large, swollen belly, known as a pot belly, is a hallmark sign, resulting from fluid accumulation and an enlarged fatty liver.
Hair and Skin Changes: The condition causes hair to become thin, brittle, and discolored (reddish-brown or yellow), and the skin may develop a dry, flaky, or peeling rash.
Muscle Wasting: Despite the misleading appearance of weight, kwashiorkor leads to severe muscle mass depletion, making limbs appear thin and emaciated.
Irritability and Apathy: Behavioral changes, such as extreme irritability, lethargy, and a general lack of interest, are common signs.
Stunted Growth: Affected children experience significant growth retardation and fail to gain weight at a normal rate.
Weakened Immune System: Severe protein deficiency compromises the immune system, leading to an increased frequency and severity of infections.

What is Kwashiorkor?

Kwashiorkor is a severe form of protein-energy malnutrition (PEM), primarily affecting children who consume insufficient protein, often despite adequate carbohydrate intake. The name is thought to mean "the sickness the older child gets when the next baby is born," referencing a child being weaned onto a low-protein diet after a new sibling arrives. Unlike marasmus, which involves deficiencies in both calories and protein, kwashiorkor is defined by edema. This condition is most common in developing countries but can occur elsewhere with severe dietary limitations or chronic illnesses.

The Hallmarks of Kwashiorkor: A Common Symptom

The most definitive answer to the question, "Which of the following is a common symptom of kwashiorkor?", is edema. This swelling, particularly in the ankles, feet, hands, and face, is the key feature differentiating kwashiorkor from other forms of malnutrition. Fluid accumulation also often causes a distended belly, which can hide the underlying malnutrition. This swelling occurs due to low levels of plasma proteins like albumin, which reduces oncotic pressure and allows fluid to enter tissues.

Distinct Physical Manifestations

Besides edema, kwashiorkor involves other recognizable physical signs:

Skin changes such as dryness, peeling, or hyperpigmented patches.
Hair changes including discoloration, brittleness, and loss.
Muscle wasting despite swelling.
Fatty liver.
Delayed growth.

Behavioral and Systemic Signs

Kwashiorkor also affects behavior and overall health. Symptoms include:

Irritability and apathy.
A weakened immune system.
Loss of appetite.

Kwashiorkor vs. Marasmus: A Symptom Comparison

Differentiating kwashiorkor and marasmus is vital for treatment. Both are severe PEM, but their symptoms differ.


Feature	Kwashiorkor	Marasmus
Edema	Present, bilateral pitting.	Absent.
Body Appearance	Swollen, especially abdomen, masking wasting.	Emaciated, “skin and bones” with severe wasting.
Subcutaneous Fat	May be present.	Severely depleted.
Hair/Skin Changes	Common, including discoloration and flaky skin.	Less common, dry/wrinkled skin.
Liver	Often enlarged/fatty.	No enlargement.

Causes and Risk Factors

Severe protein deficiency is the main cause, often combined with a carbohydrate-heavy diet. Other factors include:

Weaning onto low-protein diets.
Infections.
Socioeconomic factors like poverty.

Diagnosis and Treatment

Diagnosis involves physical examination and blood tests. Treatment focuses on cautious nutritional rehabilitation, starting with stabilization before gradually reintroducing protein and calories.

Prevention and Long-Term Outlook

Prevention requires ensuring adequate nutrition, promoting breastfeeding, and introducing appropriate complementary foods. Early detection and treatment are crucial. Timely intervention can lead to full recovery, but delayed treatment can result in lasting issues or be fatal. Consistent access to a protein-rich diet is key for prevention.

Conclusion

Edema is the most common and defining symptom of kwashiorkor, caused by severe protein deficiency. This, along with other signs, helps distinguish it from other malnutrition forms. Recognizing these symptoms is essential for prompt diagnosis and treatment, improving outcomes.

Authoritative Link: World Health Organization on Malnutrition

Frequently Asked Questions

The main cause of kwashiorkor is a severe deficiency of protein in the diet, which occurs even when calorie intake from carbohydrates is adequate.

The main difference is the presence of edema in kwashiorkor due to fluid retention, while marasmus is characterized by severe muscle and fat wasting without swelling.

Edema in kwashiorkor is caused by low levels of albumin in the blood. Since albumin is a protein responsible for maintaining oncotic pressure, its deficiency allows fluid to leak from blood vessels into surrounding tissues.

While it is most commonly associated with children, kwashiorkor can affect adults with severe dietary restrictions or underlying chronic illnesses that impact nutrient absorption.

Treatment involves a cautious nutritional rehabilitation plan. It begins with stabilizing the patient and then gradually reintroducing protein and calories through therapeutic foods.

Yes, if treatment is delayed, it can lead to long-term consequences such as permanent stunted growth, physical and mental disabilities, and potential organ damage.

Prevention involves ensuring access to a balanced diet with adequate protein, promoting proper breastfeeding and weaning practices, and addressing underlying factors like poverty and food insecurity.

The 'flag sign' in hair, where alternating light and dark bands are visible, indicates alternating periods of poor and adequate protein intake.