Approach Considerations

Multiple coexisting precipitants can lead to malnutrition in persons with failure to thrive.^[10]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]

Blood culture: Infection
Complete blood cell count: Anemia, infection
Erythrocyte sedimentation rate (ESR), C-reactive protein levels: Inflammation
Growth hormone, testosterone (men): Endocrine deficiency
HIV, rapid plasma reagin (RPR) test: Infection
Purified protein derivative (PPD) testing: Tuberculosis
Serum albumin and cholesterol levels: Malnutrition
Serum blood urea nitrogen (BUN) and creatinine levels: Dehydration, renal failure
Serum electrolyte levels: Electrolyte imbalance
Serum glucose level: Diabetes
Thyroid-stimulating hormone level: Thyroid disease
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.

Treatment & Management

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