Kwashiorkor is diagnosed in growth-retarded children along with –
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 malnutrition

If 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.

Marasmus

Marasmus is characterized by gross wasting of muscles and subcutaneous tissues resulting in emaciation, marked stunting and no oedema.

Kwashiorkor

The classical triad of kwashiorkor is markedly retarded growth, psychomotor (mental) changes and oedema.
Edema and mental changes
Hypopigmentation and anemia
Edema and hypopigmentation
hepatomegaly and anemia