Sandbox: malabsorption: Difference between revisions

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{| style="border: 0px; font-size: 100%; margin: 3px;" align="center"
{| style="border: 0px; font-size: 100%; margin: 3px;" align="center"
!
! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" |Cause
! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" |Cause
! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" |Peak age of onset
! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" |Peak age of onset
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! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" |Gold standard diagnosis
! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" |Gold standard diagnosis
|-
|-
!
! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |Fever
! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |Fever
! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |Abdominal pain
! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |Abdominal pain
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! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |Weight loss
! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |Weight loss
|-
|-
!
! align="center" style="background:#4479BA; color: #FFFFFF;" |Watery
! align="center" style="background:#4479BA; color: #FFFFFF;" |Watery
! align="center" style="background:#4479BA; color: #FFFFFF;" |Fatty
! align="center" style="background:#4479BA; color: #FFFFFF;" |Fatty
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! align="center" style="background:#4479BA; color: #FFFFFF;" |Other lab findings
! align="center" style="background:#4479BA; color: #FFFFFF;" |Other lab findings
|-
|-
!
! align="center" style="background:#DCDCDC;" |[[Whipple's disease]]
! align="center" style="background:#DCDCDC;" |[[Whipple's disease]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |40-60
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |40-60
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* [[PCR]] testing
* [[PCR]] testing
|-
|-
!
! align="center" style="background:#DCDCDC;" |[[Celiac disease]]
! align="center" style="background:#DCDCDC;" |[[Celiac disease]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Childhood
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Childhood
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* [[IgA]] tissue transglutaminase antibody
* [[IgA]] tissue transglutaminase antibody
|-
|-
!
! align="center" style="background:#DCDCDC;" |[[Tropical sprue]]
! align="center" style="background:#DCDCDC;" |[[Tropical sprue]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Any age
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Any age
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* Diagnosis of exclusion
* Diagnosis of exclusion
|-
|-
!
! align="center" style="background:#DCDCDC;" |[[Crohns disease]]
! align="center" style="background:#DCDCDC;" |[[Crohns disease]]
| align="center" style="background:#F5F5F5;" | Young adults
| align="center" style="background:#F5F5F5;" | Young adults
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* [[Colonoscopy]] with [[biopsy]]
* [[Colonoscopy]] with [[biopsy]]
|-
|-
!
! align="center" style="background:#DCDCDC;" |[[Ulcerative colitis]]
! align="center" style="background:#DCDCDC;" |[[Ulcerative colitis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Young adults
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Young adults
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* [[Colonoscopy]] with [[biopsy]]
* [[Colonoscopy]] with [[biopsy]]
|-
|-
!
! align="center" style="background:#DCDCDC;" |[[Cystic fibrosis]]
! align="center" style="background:#DCDCDC;" |[[Cystic fibrosis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Childhood
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Childhood
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* Elevated [[Sweat chloride test|sweat chloride]] ≥60 mmol/L
* Elevated [[Sweat chloride test|sweat chloride]] ≥60 mmol/L
|-
|-
!
! align="center" style="background:#DCDCDC;" |[[VIPoma]]
! align="center" style="background:#DCDCDC;" |[[VIPoma]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |30-50
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |30-50
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* Followed by imaging
* Followed by imaging
|-
|-
!
! align="center" style="background:#DCDCDC;" |[[Zollinger-Ellison syndrome]]
! align="center" style="background:#DCDCDC;" |[[Zollinger-Ellison syndrome]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |20-50
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |20-50
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* Elevated basal or stimulated serum [[gastrin]]> 120 pg/mL
* Elevated basal or stimulated serum [[gastrin]]> 120 pg/mL
|-
|-
 
!
! align="center" style="background:#DCDCDC;" |[[Eosinophilic gastroenteritis]] 
! align="center" style="background:#DCDCDC;" |[[Eosinophilic gastroenteritis]] 
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | 30th
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | 30th
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* [[Eosinophilic]] infiltration of the [[gastrointestinal tract]] on [[biopsy]]
* [[Eosinophilic]] infiltration of the [[gastrointestinal tract]] on [[biopsy]]
|-
|-
!
! align="center" style="background:#DCDCDC;" |[[Primary bile acid malabsorption]]
! align="center" style="background:#DCDCDC;" |[[Primary bile acid malabsorption]]
| align="center" style="background:#F5F5F5;" | Childhood Adult
| align="center" style="background:#F5F5F5;" | Childhood Adult
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* Positive [[SeHCAT]]
* Positive [[SeHCAT]]
|-
|-
!
! align="center" style="background:#DCDCDC;" |[[Abetalipoproteinemia]]
! align="center" style="background:#DCDCDC;" |[[Abetalipoproteinemia]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Infancy
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Infancy
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* Clinical findings and low [[triglyceride]] and [[cholesterol]] level
* Clinical findings and low [[triglyceride]] and [[cholesterol]] level
|-
|-
!
! align="center" style="background:#DCDCDC;" |[[Microscopic colitis]]
! align="center" style="background:#DCDCDC;" |[[Microscopic colitis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |50-70
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |50-70
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** [[Lymphocytic]] [[colitis]] is characterized by ≥20 intraepithelial [[lymphocytes]] (IEL) per 100 surface epithelial cells
** [[Lymphocytic]] [[colitis]] is characterized by ≥20 intraepithelial [[lymphocytes]] (IEL) per 100 surface epithelial cells
|-
|-
!
! align="center" style="background:#DCDCDC;" |[[Hyperthyroidism]]
! align="center" style="background:#DCDCDC;" |[[Hyperthyroidism]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Any age
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Any age
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* [[TSH]]
* [[TSH]]
|-
|-
!
! align="center" style="background:#DCDCDC;" |[[Lactose intolerance]]
! align="center" style="background:#DCDCDC;" |[[Lactose intolerance]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Any age
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Any age
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* [[Lactase]] activity assay
* [[Lactase]] activity assay
|-
|-
!
! align="center" style="background:#DCDCDC;" |[[Irritable bowel syndrome]]
! align="center" style="background:#DCDCDC;" |[[Irritable bowel syndrome]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |30-50
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |30-50
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* Diagnosis of exclusion
* Diagnosis of exclusion
|-
|-
!
! align="center" style="background:#DCDCDC;" |[[Chronic pancreatitis]]
! align="center" style="background:#DCDCDC;" |[[Chronic pancreatitis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | 50-60
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | 50-60
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| style="padding: 5px 5px; background: #F5F5F5;" align="center" |  
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |  
|-
|-
!
! align="center" style="background:#DCDCDC;" |[[Cirrhosis]]
! align="center" style="background:#DCDCDC;" |[[Cirrhosis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |50-60
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |50-60
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| style="padding: 5px 5px; background: #F5F5F5;" align="center" |  
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |  
|-
|-
!
! align="center" style="background:#DCDCDC;" |[[Short bowel syndrome]]
! align="center" style="background:#DCDCDC;" |[[Short bowel syndrome]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |  
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |  
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| style="padding: 5px 5px; background: #F5F5F5;" align="center" |  
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |  
|-
|-
!
! align="center" style="background:#DCDCDC;" |Intestinal [[lymphoma]]
! align="center" style="background:#DCDCDC;" |Intestinal [[lymphoma]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |  
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |  
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| style="padding: 5px 5px; background: #F5F5F5;" align="center" |  
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |  
|-
|-
!
! align="center" style="background:#DCDCDC;" |[[Agammaglobulinemia]]
! align="center" style="background:#DCDCDC;" |[[Agammaglobulinemia]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |  
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |  
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| style="padding: 5px 5px; background: #F5F5F5;" align="center" |  
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |  
|-
|-
!
! align="center" style="background:#DCDCDC;" |Intestinal [[lymphangiectasia]]
! align="center" style="background:#DCDCDC;" |Intestinal [[lymphangiectasia]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |  
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |  
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| style="padding: 5px 5px; background: #F5F5F5;" align="center" |  
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |  
|-
|-
!
! align="center" style="background:#DCDCDC;" |[[Amyloidosis]]
! align="center" style="background:#DCDCDC;" |[[Amyloidosis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |  
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |  
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| style="padding: 5px 5px; background: #F5F5F5;" align="center" |  
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |  
|-
|-
!
! align="center" style="background:#DCDCDC;" |[[Mastocytosis]]
! align="center" style="background:#DCDCDC;" |[[Mastocytosis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |  
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |  
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| style="padding: 5px 5px; background: #F5F5F5;" align="center" |  
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |  
|-
|-
!
! align="center" style="background:#DCDCDC;" |[[Small intestinal bacterial overgrowth]]
! align="center" style="background:#DCDCDC;" |[[Small intestinal bacterial overgrowth]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |  
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |  
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| style="padding: 5px 5px; background: #F5F5F5;" align="center" |  
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |  
|-
|-
!
! align="center" style="background:#DCDCDC;" |Drug induced [[enteritis]]
! align="center" style="background:#DCDCDC;" |Drug induced [[enteritis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |  
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |  
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| style="padding: 5px 5px; background: #F5F5F5;" align="center" |  
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |  
|-
|-
! rowspan="4" |[[Infection]]
! align="center" style="background:#DCDCDC;" |[[HIV AIDS|HIV infection]]
! align="center" style="background:#DCDCDC;" |[[HIV AIDS|HIV infection]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |  
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |  

Revision as of 13:28, 20 November 2017

Abbreviations: WBC: White blood cells; Plt: Platelets, Hgb: Hemoglobin, IgE: Immunoglobulin E, IgA: Immunoglobulin A

Cause Peak age of onset History Physical exam Lab findings Additional findings Cause/Pathogenesis Gold standard diagnosis
Fever Abdominal pain Diarrhea Weight loss
Watery Fatty WBC Hgb Plt Other lab findings
Whipple's disease 40-60 ± + + + + ↓/↑
Celiac disease Childhood

Adult

- + ± ± + - -
  • IgA endomysial antibody
  • Anti-tissue transglutaminase antibody
  • Anti-gliadin antibody
  • IgA endomysial antibody
  • IgA tissue transglutaminase antibody
Tropical sprue Any age + + + + + - -
  • Diagnosis of exclusion
Crohns disease Young adults

(20th)

+ + + + +
  • Abnormal immune response to self antigens
Ulcerative colitis Young adults

(20th)

+ + + + +
  • Hypoalbuminemia
  • Hypokalemia
  • Hypomagnesemia
  • Iron deficiency
  • Elevated ESR
  • Elevated CRP
  • Abnormal immune response to self antigens
Cystic fibrosis Childhood

Adult

± + - + + - -
  • Positive DNA analysis for CFTR
  • Evaluated nasal transepithelial potential difference (NPD)
VIPoma 30-50 - + + + + - - -
  • Primary secretory tumor
  • Elevated VIP levels
  • Followed by imaging
Zollinger-Ellison syndrome 20-50 - + + + + - -
  • Elevated basal or stimulated serum gastrin> 120 pg/mL
Eosinophilic gastroenteritis  30th - + + + + - -
Primary bile acid malabsorption Childhood Adult - + + + + - -
Abetalipoproteinemia Infancy

Adult

- + + + + - - -
Microscopic colitis 50-70 - + + - + - -
Hyperthyroidism Any age ± + + - + - - -
  • Elevated T4
  • Elevated T3
  • Decreased TSH
Lactose intolerance Any age - + + - - - - -
Irritable bowel syndrome 30-50 - ± ± ± - - - -
  • Diagnosis of exclusion
Chronic pancreatitis 50-60 - + + + +
Cirrhosis 50-60 + + + + +
Short bowel syndrome
Intestinal lymphoma
Agammaglobulinemia
Intestinal lymphangiectasia
Amyloidosis
Mastocytosis
Small intestinal bacterial overgrowth
Drug induced enteritis
Infection HIV infection
Giardiasis
Strongyloidiasis
Tuberculosis