Approach Considerations
Multiple coexisting precipitants can lead to malnutrition in persons with failure to thrive. A comprehensive history and physical examination is key to identifying the underlying precipitants. Based on the initial assessment, further workup can be performed to confirm or rule out possible suspected etiologies.
Laboratory Studies
Based on the history and physical examination, laboratory studies can be performed to further investigate the underlying etiology for failure to thrive. The following is a list of tests and conditions for which these tests may be helpful: [1]
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Blood culture: Infection
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Complete blood cell count: Anemia, infection
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Erythrocyte sedimentation rate (ESR), C-reactive protein levels: Inflammation
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Growth hormone, testosterone (men): Endocrine deficiency
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HIV, rapid plasma reagin (RPR) test: Infection
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Purified protein derivative (PPD) testing: Tuberculosis
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Serum albumin and cholesterol levels: Malnutrition
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Serum blood urea nitrogen (BUN) and creatinine levels: Dehydration, renal failure
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Serum electrolyte levels: Electrolyte imbalance
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Serum glucose level: Diabetes
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Thyroid-stimulating hormone level: Thyroid disease
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Urinalysis: Infection, renal failure, dehydration
Imaging Studies
Imaging studies such as radiography and CT scanning can be performed depending on suspected etiologies based on history and examination findings to further investigate and confirm the diagnosis.
Chest radiography can be used to evaluate for infection and/or malignancy.
CT scanning and MRI can be performed to assess for malignancy and/or abscesses.
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Management of failure to thrive.
