What combination of clinical features would prompt classification as marasmic kwashiorkor rather than either marasmus or kwashiorkor alone?

Moderate obesity with localized edema but normal growth percentiles, indicating mixed metabolic syndrome rather than marasmic kwashiorkor.

Acute severe diarrhea without weight loss or edema, which signals an infectious etiology rather than combined PEM.

Presence of severe wasting (loss of subcutaneous fat and muscle) together with peripheral edema and some hypoalbuminemia—i.e., concurrent signs of both energy deficiency and protein-deficiency edema.

Isolated stunting with good muscle mass and no edema, a pattern consistent with chronic undernutrition but not the mixed syndrome.