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Marasmus

Disease Details

Family Health Simplified

Description
Marasmus is a severe form of malnutrition caused by a significant deficiency in calorie and protein intake, leading to extreme wasting and stunted growth, particularly in young children.
Type
Marasmus is not a genetic disorder; it is a type of severe malnutrition caused by a significant deficiency in calories and protein. It typically occurs due to inadequate food intake, often in the context of poverty, famine, or impaired absorption of nutrients.
Signs And Symptoms
Marasmus is commonly represented by a shrunken, wasted appearance, loss of muscle mass and subcutaneous fat mass. Due to the deficiency in macronutrients and caloric intake, specifically protein and adult survivors that impact development. Other long term effects of marasmus are the increased risks for pancreatic beta-cell dysfunction which leads to glucose intolerance and type 2 diabetes. This may lead to reduced muscle mass, and increased visceral fat. Moreover, there are metabolic implications including reduced insulin sensitivity and impaired glucose metabolism. There is also an increased risk of other NCDs (Non-communicable diseases) as well as CVRFs (Cardiovascular risk factors). Not only are the survivors of marasmus impacted, but their offspring as well. There is an association with survivors and their offspring having a low birth weight. There are also long term effects related to gene methylation. Marasmus adult survivors may have changes in gene expression in regards to immunity, growth and glucose metabolism.
Prognosis
Marasmus is a severe form of malnutrition characterized by energy deficiency. The prognosis for marasmus depends on several factors including the timeliness and adequacy of medical intervention, the presence of any underlying health conditions, and the patient’s overall health status. With prompt and appropriate nutritional rehabilitation, rehydration, and management of any infections or complications, many affected individuals can recover over time. However, without intervention, marasmus can lead to severe long-term health issues or be fatal.
Onset
For marasmus:

Onset: Marasmus generally develops over a period of time due to prolonged severe deficiency of calories and protein. It is often seen in infants and young children, especially in regions with inadequate food supply.

Nan: The term "nan" is unclear in this context. If you meant nutritional aspects, marasmus involves severe wasting of muscle and fat tissues resulting from inadequate intake of virtually all nutrients, with notable deficiencies in protein and calories.
Prevalence
Marasmus is a severe form of malnutrition characterized by energy deficiency. It primarily affects children in developing countries due to factors like poverty, lack of food, and inadequate healthcare. Specific prevalence data on marasmus is not available due to variations across regions and populations, but it is a significant concern in areas suffering from food insecurity and famine. It is part of the broader category of Protein-Energy Malnutrition (PEM), which affects millions of young children worldwide.
Epidemiology
Marasmus is a severe form of protein-energy malnutrition characterized by energy deficiency. It primarily affects children under the age of five, particularly in developing countries.

**Epidemiology:**
- **Prevalence:** Marasmus is most prevalent in regions with high rates of poverty, food insecurity, and limited access to healthcare, including parts of sub-Saharan Africa, South Asia, and Latin America.
- **Risk Factors:** Contributing factors include inadequate breastfeeding, improper weaning, infections (e.g., diarrhea, respiratory infections), and economic challenges.

**NaN:**
This term typically stands for "Not a Number," which is used in computing and might not be pertinent in a medical context. If you have a specific aspect or parameter related to marasmus in mind, please clarify.
Intractability
Marasmus is not considered intractable. It is a severe form of malnutrition caused by a significant deficiency in caloric intake. With appropriate medical intervention, nutritional rehabilitation, and addressing underlying causes, recovery is possible. Early detection and treatment are crucial for better outcomes.
Disease Severity
Marasmus:

Disease Severity: Severe, as it involves extreme malnutrition and wasting, leading to significant loss of muscle and fat tissues. It requires urgent medical attention to address underlying nutritional deficiencies and prevent life-threatening complications.
Healthcare Professionals
Disease Ontology ID - DOID:12328
Pathophysiology
Marasmus is characterized by severe malnutrition caused by an overall deficit in caloric intake, including both protein and energy sources. The pathophysiology involves the body's adaptive response to prolonged inadequate nutrient supply, resulting in the utilization of fat stores and muscle protein for energy. This leads to significant wasting and weight loss. Key features include loss of subcutaneous fat, muscle atrophy, and stunted growth. The condition also impairs immune function and increases susceptibility to infections. Additionally, the body's metabolic rate decreases as a means to conserve energy.
Carrier Status
Marasmus is not a genetic condition with a carrier status. It is a form of severe malnutrition primarily seen in children and adults due to inadequate intake of protein and calories. The term "carrier status" does not apply to this condition.
Mechanism
Marasmus is a severe form of malnutrition primarily caused by a significant deficiency in caloric and protein intake. Here is detailed information on its mechanisms and molecular mechanisms:

**Mechanism:**
1. **Nutrient Deficiency:** The primary mechanism of marasmus is the insufficient intake of calories, proteins, and essential nutrients. This leads to the body depleting its energy reserves.
2. **Catabolism:** The body begins to break down its own tissues, including fat and muscle, to meet energy needs. This results in significant loss of body mass and muscle wasting.
3. **Immunosuppression:** The lack of nutrients weakens the immune system, making the body more susceptible to infections.
4. **Physiological Changes:** There is a noticeable reduction in basal metabolic rate (BMR) as the body tries to conserve energy.

**Molecular Mechanisms:**
1. **Protein-Energy Malnutrition:** In marasmus, there is a reduction in the availability of amino acids due to inadequate protein intake. This leads to decreased synthesis of critical proteins needed for various bodily functions, including enzymes, hormones, and immune proteins.
2. **Hormonal Imbalances:** The condition leads to alterations in hormone levels, such as decreased insulin and increased cortisol and catecholamines, which promote catabolism (breakdown of body tissues).
3. **Autophagy and Muscle Degradation:** Cellular autophagy processes are upregulated as an adaptive response to nutrient scarcity, breaking down cellular components to provide essential nutrients.
4. **Inflammatory Response:** Chronic malnutrition can lead to low-level chronic inflammation, characterized by elevated levels of pro-inflammatory cytokines. This inflammatory state further contributes to the degradation of muscle proteins.
5. **Mitochondrial Dysfunction:** Energy production in cells becomes inefficient due to mitochondrial dysfunction, leading to reduced ATP production, increased oxidative stress, and cellular damage.
6. **Downregulation of Growth Factors:** There is decreased activity of growth factors like insulin-like growth factor 1 (IGF-1), which normally promote cell growth and maintenance.

By understanding these mechanisms, one can better appreciate the severe impact of marasmus on the body and the importance of adequate nutrition in preventing this condition.
Treatment
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. 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. 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.
Compassionate Use Treatment
Marasmus is a severe form of malnutrition characterized by energy deficiency. It primarily affects children and involves wasting of muscle and fat tissues.

1. **Compassionate Use Treatment**:
- There is no specific "compassionate use" medication for marasmus as it is essentially a condition of chronic undernourishment. However, therapeutic interventions focus on gradual refeeding and correction of nutritional deficiencies. Ready-to-use therapeutic foods (RUTF), like Plumpy'Nut, are often employed in emergency settings to treat severe acute malnutrition.

2. **Off-label or Experimental Treatments**:
- Off-label treatments might involve the use of certain micronutrient supplements or probiotics that are not specifically approved for malnutrition but could help in improving gut health and overall nutritional status.
- Experimental treatments and interventions may include novel therapeutic nutritional formulations being tested for effectiveness in reversing severe malnutrition more rapidly or addressing associated complications like infection control and gut flora restoration.

The management strategy typically includes staged refeeding protocols, hydration, electrolyte balance, and gradual introduction of calories and proteins to avoid refeeding syndrome.
Lifestyle Recommendations
**Lifestyle Recommendations for Marasmus:**

1. **Balanced Diet:** Ensure adequate intake of essential nutrients. Opt for meals rich in proteins, vitamins, and minerals.
2. **Hydration:** Maintain proper hydration levels. Clean, safe drinking water is essential.
3. **Hygiene:** Maintain hygiene to prevent infections. Regular hand washing and clean food preparation practices are crucial.
4. **Regular Monitoring:** Frequent health check-ups to monitor growth and development.
5. **Supplementation:** Consider vitamin and mineral supplements as recommended by a healthcare provider.
6. **Rest and Recovery:** Ensure adequate rest to support recovery and overall health.
7. **Education and Awareness:** Understand the importance of nutrition and seek guidance from healthcare professionals or nutritionists.

Note: Always consult healthcare providers for personalized advice.
Medication
Marasmus is not typically treated with specific medications. Instead, the focus is on gradually restoring nutrition to the affected individual. Nutritional rehabilitation includes a carefully planned diet that begins with easily digestible foods and gradually introduces more complex and energy-dense foods. In some cases, vitamin and mineral supplements are provided to address deficiencies. If infections are present, appropriate antibiotics may be administered. The goal is to carefully restore the individual's nutritional status while monitoring for potential complications.
Repurposable Drugs
Marasmus is a form of severe malnutrition characterized by energy deficiency. It primarily affects children and can lead to significant weight loss, muscle wasting, and weakened immunity. There are no specific drugs repurposed for marasmus itself; the primary treatment involves nutritional rehabilitation, addressing fluid and electrolyte imbalances, and treating any infections or complications. Refeeding should be gradual to prevent refeeding syndrome.

Some components that may be included in the treatment plan:
1. Ready-to-Use Therapeutic Foods (RUTF)
2. Multivitamins and mineral supplements
3. Oral rehydration salts (ORS) for dehydration

Clinical management includes monitoring and supportive care to ensure successful recovery.
Metabolites
Marasmus is a severe form of malnutrition characterized by energy deficiency. In marasmus, the body undergoes extensive muscle and fat loss to compensate for the lack of dietary energy. As a result, key metabolic changes occur:

1. **Glucose**: Levels often decrease as the body’s glycogen stores are quickly depleted.
2. **Amino Acids**: Breakdown of muscle protein leads to increased levels of circulating amino acids initially, but these eventually decline as protein stores are exhausted.
3. **Ketone Bodies**: As fat stores become a major energy source, ketone body production increases.
4. **Fatty Acids**: Free fatty acid levels rise due to the breakdown of fat stores.
5. **Cortisol**: Levels may be elevated, promoting protein catabolism and gluconeogenesis.

These metabolic changes reflect the body's adaptations to prolonged energy insufficiency, aiming to maintain vital functions.
Nutraceuticals
Marasmus is a severe form of malnutrition caused by a significant deficiency in calorie intake, leading to wasting and loss of muscle mass and fat stores. Management primarily involves nutritional rehabilitation. Nutraceuticals can play a role in this process:

1. **Protein Supplements:** Essential for rebuilding muscle mass and improving overall nutritional status.
2. **Multivitamins:** Important for addressing micronutrient deficiencies commonly seen in marasmus, such as vitamin A, vitamin D, and B-complex vitamins.
3. **Minerals:** Supplements like zinc, iron, and magnesium can help correct deficiencies and aid in the recovery process.
4. **Fatty Acids:** Omega-3 and omega-6 fatty acids can be beneficial in improving immune function and overall health.

Nanotechnology (nan) in the context of marasmus has emerging potential:

1. **Nano-Encapsulation:** This technique can improve the delivery and absorption of essential nutrients, making them more effective in small, malnourished bodies.
2. **Nanoemulsions:** These can be used to enhance the bioavailability of fat-soluble vitamins and other important nutrients.

Research is ongoing to fully understand and utilize these advanced technologies in the treatment of marasmus effectively.
Peptides
Marasmus is a form of severe malnutrition characterized by energy deficiency. It primarily affects infants and young children.

**Peptides:**
- Peptides are organic compounds that consist of amino acids, which are the building blocks of proteins. Individuals with marasmus suffer from an overall lack of calories, including protein. This deficiency in protein intake affects the body's capacity to produce essential peptides and proteins needed for growth and repair.

**Nan:**
- If "nan" refers to "nutritional assessment need," then it is essential to assess the nutritional needs of individuals diagnosed with marasmus. This includes evaluating their intake of calories, proteins, vitamins, and minerals to develop an appropriate dietary intervention plan. If "nan" refers to something else, please provide more context for an accurate response.