All of the following conditions are observed in Marasmus, except –
Changes in body composition in P.E.M. 
Fluid considerations-

Total body water in malnourished children is increased to 70-80% of body weight as compared to 60% in age-matched well-nourished controls.
The activity of the sodium pump* is reduced.

Metabolic alterations.

B.M.R. is reduced by 30% and energy expenditure due to inactivity is very low
The child may behave like poikilotherm.

Endocrine changes.

Insulin levels are reduced (child has glucose intolerance)
Cortisol and growth hormone levels are increased.

Cardiovascular system

Cardiac output and stroke volume are reduced
Blood pressure is low and renal perfusion is compromised.

Renal function

Glomerular filtration rate and renal plasma flow are reduced in severe P.E.M.
Urinary phosphate and sodium excretion are reduced.
Hepatomegaly
Muscle wasting
Low insulin levels
Extreme weakness