this 10 year boy came to my opd with complaint of short stature (height -93cm) with not gaining weight and significant abdominal distension and off and on loose stool, no urinary complaints o/e- pallor + no icterus, no murmer enlarged liver CBC,RFT,LFT, Serum electrolyte, chest x-ray x-ray wrist sent and report awaitef what could be possible DX


Diagnosis: • Celiac Sprue Management: 1. IgA TTG (first test) 2. Deodenal Biopsy ( a must for confirmation) 3. Gluten challenge (most helpful) 4. Genetic testing (optional) Histologic Staging of celiac disease via a deodenal biopsy is mandatory before treatment is started. Treatment: • Diet - Gluten / Gliadin free diet. In resistant and unresponsive patients, • Corticosteroids - Prednisolone 40 to 60 mg per day in two doses. Differential diagnosis includes: - Budd chiaroscuro Syndrome - Extrahepatic Portal Vein Obstruction - small intestinal lymphoma But these are highly unlikely in view of the clinical picture.

Coeliac disease Do ttg IGA This is only and sure diagnosis Please update afterwards

Celiac disease Give gluten free diet Oral multivitamin, calcium,vitD, iron supplements Plot growth chart & observe... D/D hypothyroidism, GH deficiency

Celiac disease. TTIg

Coeliac disease

RTAcidosis serelectrolytes karyotypomg hc03 levels

Rule out Hypothyroidism And Celiac disease

Coeliac disease

This pt final diagnosis came to be celiac disease

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