Marasmic kwashiorkor

Marasmic kwashiorkor is a severe form of protein-energy malnutrition characterized by a combination of features from both marasmus and kwashiorkor. Patients present with extreme emaciation, muscle wasting, and growth retardation, alongside edema, skin lesions, and hair changes. This condition reflects a chronic deficiency of both protein and calories.

This code is used when documentation clearly indicates a diagnosis of marasmic kwashiorkor, often seen in pediatric populations in developing countries or in contexts of severe food insecurity. Clinical documentation should describe both the severe wasting (marasmus component) and the edematous features (kwashiorkor component).

• Differentiate from pure marasmus (E41) or pure kwashiorkor (E40) based on the presence of both wasting and edema.
• Always review the physician's diagnostic statement for the specific term "marasmic kwashiorkor."
• Consider sequencing with codes for associated complications, such as infections or electrolyte imbalances.