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We have investigated the pathophysiology and optimum treatment of PCM in Northern Thai children over the past 10 years and have developed what we consider to be an improved scoring system for the diagnosis of the three major forms of severe protein calorie malnutrition, namely: marasmus, marasmic kwashiorkor, and kwashiorkor. We feel that it gives a more definitive classification of these subgroups of PCM than any other system. It takes into account anthropometric and laboratory parameters, as well as clinical ones, and permits hospitals and metabolic units in various parts of the world to make better comparisons of their results.Various aspects of the pathophysiology of PCM have been studied, including hematopoietic, endocrine, and metabolic aspects. We have developed a plan of therapy which has reduced mortality to 6-7%. In support of our plan of treatment, we have presented the clinical and biochemical data, and have demonstrated the protein and calorie requirements for the optimum treatment of severe protein calorie malnutrition.The distribution of the three forms of protein calorie malnutrition clearly differs widely in affected countries throughout the world. In some, marasmus is more prevalent; in others, kwashiorkor. Investigators not familiar with the global distribution of the types of the disease may be regarding their particular population of children in a special way.

Clinical aspects of protein deficiency with special reference to protein calorie malnutrition (PCM) in children.