Kwashiorkor is an acute form of childhood protein-energy malnutrition characterized by edema, irritability, anorexia, ulcerating dermatoses, and an enlarged liver. The presence of edema caused by poor nutrition defines kwashiorkor. It was thought to be caused by insufficient protein consumption but with sufficient calorie intake, distinguishing it from marasmus. More recently, micronutrient and antioxidant deficiencies have come to be recognized as contributing to kwashiorkor as well. Cases in the developed world are rare. Six million children die of hunger every year.