<prompt> Kwashiorkor is diagnosed in growth-retarded children along withEdema and mental changesHypopigmentation and anemiaEdema and hypopigmentationhepatomegaly and anemia  <response>: Protein-energy malnutrition PEM is a spectrum of conditions ranging from mild undernutrition of extreme forms of malnutrition, i.e. Marasmus and Kwashiorkor.Most of the child suffer from mild to moderate nutritional deficit and extreme forms marasmus and kwashiorkor account only for a small proportion of cases of malnutrition.Mild to moderate malnutritionIf the dietary intake is deficient for a short period, the body adapts its metabolism to compensate for the deficit to some extent. Moderately malnourished children appear slower and less energetic.Growth lag is more pronounced in weight than the length.Head circumference is not reduced significantly.MarasmusMarasmus is characterized by gross wasting of muscles and subcutaneous tissues resulting in emaciation, marked stunting and no oedema.KwashiorkorThe classical triad of kwashiorkor is markedly retarded growth, psychomotor mental changes and oedema. 