Which of the following is not a sign of kwashiorkor?

Kwashiorkor is a form of malnutrition that is primarily due to a deficiency in protein despite the potential presence of adequate caloric intake. It is characterized by specific clinical features that help distinguish it from other forms of malnutrition.

Depigmentation of hair and skin, edema in the limbs, and apathy are all associated with kwashiorkor. Depigmentation occurs due to disrupted melanin synthesis, often due to low protein levels. Edema, which is swelling caused by fluid retention, is a hallmark of kwashiorkor and is especially noticeable in the limbs and abdomen. Apathy, or lack of interest and enthusiasm, can be seen in children suffering from this condition as a result of overall physical and mental distress.

In contrast, emaciation is more characteristic of marasmus, another form of malnutrition that results from a severe deficiency in both calories and protein. Marasmus leads to significant weight loss and a wasted appearance, contrasting with the often swollen appearance of individuals with kwashiorkor. Hence, the presence of emaciation does not align with the defining features of kwashiorkor, making it the correct choice when identifying what is not a sign of this condition.