This 2 1/2 yes old weighing 7kg with recurrent episodes of diarrhoea and abdominal distension.height/length is 79cm. .. ...suggested work up please?



As child has failure to thrive and recurrent diarrhea with abdominal distension. So rule out 1.Celiac disease 2.Hypothyroidism - although in it constipation is more common but still thyroid disorders should be ruled in a child with FTT child. 3.HIV 4.Any acynotic congenital heart Disease. Rickets can be alone also or can be present with any malabsorption syndrome.

there is failure to thrive c e/0 rickets clinically. Rickets in malnourished child c recurrent GI infn,needs evaluation for renal rickets.abg,Sr cal,posporus,electrolyte s,Sr alk.phosphatase,montoux test.

PEM , marasmic appearance, malabsorption syndrome can be a cause , chronic worm infestation, HIV should be ruled out , primary immunodeficiency syndrome can also be kept in mind, renal rickets. work up : stool routine, HiV , USG abd, CXR, LFT , RFT

As all of you have opined we treated this as SAM as per WHO protocol.treated for sepsis...corrected metabolic disbands like hypokalemia. ..tTGA values are 47.5units (ref.values are.... <20 negative. ....20 to 30...mild elevations....>30 very strong the child us out on gluten free diet....let's wait for next due visit and hope for improvement with good improved photograph of the child. ..Thank you all for your active participation. ...A wonderful group indeed...

So its celiac disease....niw there will be good growth on gluten free diet Kindly take care of nutrition

case of pem, marasmic kwashiorkar as faliure to thrive,abdominal distention,frontal bossing n protuberent Costco condral juction in pic so possb of tickets also .Do workup electrolytes,,cbc,stool exam,

case of pem nutrition

coeliac disease with malnutrition and rickets

baby having frontal bossing with PEM like condition

dietexplain according to chronic diarrhoea,

PEM and all associated mineral vitamin deficiencies

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