Clinical manifestations Nonedematous PEM (marasmus) Failure to gain weight Irrita bility Weight loss and listlessness skin become wrinkled and loose Subcutaneous fat disappear Muscle: atrophy, hypotonia Pulse slow Constipation, a starvation diarrheaClinical manifestations Nonedematous PEM (marasmus) ➢ Failure to gain weight ➢ Irritability ➢ Weight loss and listlessness ➢ skin become wrinkled and loose ➢ Subcutaneous fat disappear ➢ Muscle: atrophy, hypotonia ➢ Pulse slow ➢ Constipation, a starvation diarrhea