Malabsorption laboratory findings: Difference between revisions
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(Created page with "__NOTOC__ {{Malabsorption}} {{CMG}} ==Diagnosis== There is no specific test for Malabsorption. As for most medical conditions, investigation is guided by symptoms and signs. ...") |
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*Routine blood tests may reveal [[anaemia]], high [[ESR]] or low [[serum albumin|albumin]]; which has high sensitivity for presence of organic disease <ref>{{cite journal |author=Bertomeu A, Ros E, Barragán V, Sachje L, Navarro S |title=Chronic diarrhea with normal stool and colonic examinations: organic or functional? |journal=J. Clin. Gastroenterol. |volume=13 |issue=5 |pages=531-6 |year=1991 |pmid=1744388}}</ref><ref>{{cite journal |author=Read N, Krejs G, Read M, Santa Ana C, Morawski S, Fordtran J |title=Chronic diarrhea of unknown origin |journal=Gastroenterology |volume=78 |issue=2 |pages=264-71 |year=1980 |pmid=7350049}}</ref>. In this setting, [[Microcytic#Microcytic anaemia|microcytic anaemia]] usually implies iron deficiency and [[macrocytosis]] can be from impaired [[folic acid]] or [[B12]] absorption or both. Low cholesterol or triglyceride may give clue toward fat malabsorption as low calcium and phosphate toward [[osteomalacia]] from low vitamin D. | *Routine blood tests may reveal [[anaemia]], high [[ESR]] or low [[serum albumin|albumin]]; which has high sensitivity for presence of organic disease <ref>{{cite journal |author=Bertomeu A, Ros E, Barragán V, Sachje L, Navarro S |title=Chronic diarrhea with normal stool and colonic examinations: organic or functional? |journal=J. Clin. Gastroenterol. |volume=13 |issue=5 |pages=531-6 |year=1991 |pmid=1744388}}</ref><ref>{{cite journal |author=Read N, Krejs G, Read M, Santa Ana C, Morawski S, Fordtran J |title=Chronic diarrhea of unknown origin |journal=Gastroenterology |volume=78 |issue=2 |pages=264-71 |year=1980 |pmid=7350049}}</ref>. In this setting, [[Microcytic#Microcytic anaemia|microcytic anaemia]] usually implies iron deficiency and [[macrocytosis]] can be from impaired [[folic acid]] or [[B12]] absorption or both. Low cholesterol or triglyceride may give clue toward fat malabsorption as low calcium and phosphate toward [[osteomalacia]] from low vitamin D. | ||
*Specific vitamins like [[vitamin D]] or [[micro nutrient]] like zinc levels can be checked. Fat soluble vitamins (A, D, E & K) are affected in fat malabsorption. Prolonged [[prothrombin time]] can be from [[vitamin K]] deficiency. | *Specific vitamins like [[vitamin D]] or [[micro nutrient]] like zinc levels can be checked. Fat soluble vitamins (A, D, E & K) are affected in fat malabsorption. Prolonged [[prothrombin time]] can be from [[vitamin K]] deficiency. | ||
*Serological studies | *Serological studies: | ||
:Specific tests are carried out to determine underlying cause. | :Specific tests are carried out to determine underlying cause. | ||
:[[IgA]] tissue trans glutamate or IgA antiendomysium assay for [[Coeliac disease|gluten sensitive enteropathy]]. | :[[IgA]] tissue trans glutamate or IgA antiendomysium assay for [[Coeliac disease|gluten sensitive enteropathy]]. | ||
Revision as of 18:42, 30 November 2012
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Malabsorption |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]
Diagnosis
There is no specific test for Malabsorption. As for most medical conditions, investigation is guided by symptoms and signs. Moreover, tests for pancreatic function are complex and varies widely between centers.
Blood Tests
- Routine blood tests may reveal anaemia, high ESR or low albumin; which has high sensitivity for presence of organic disease [1][2]. In this setting, microcytic anaemia usually implies iron deficiency and macrocytosis can be from impaired folic acid or B12 absorption or both. Low cholesterol or triglyceride may give clue toward fat malabsorption as low calcium and phosphate toward osteomalacia from low vitamin D.
- Specific vitamins like vitamin D or micro nutrient like zinc levels can be checked. Fat soluble vitamins (A, D, E & K) are affected in fat malabsorption. Prolonged prothrombin time can be from vitamin K deficiency.
- Serological studies:
- Specific tests are carried out to determine underlying cause.
- IgA tissue trans glutamate or IgA antiendomysium assay for gluten sensitive enteropathy.
Stool Studies
- Microscopy is particularly useful in diarrhoea, may show protozoa like giardia, ova, cyst and other infective agents.
- Fecal fat study to diagnose steatorrhoea is less frequently performed nowadays.
- Low elastase is indicative of pancreatic insufficiency. Chymotrypsin and pancreolauryl can be assessed as well[3]
References
- ↑ Bertomeu A, Ros E, Barragán V, Sachje L, Navarro S (1991). "Chronic diarrhea with normal stool and colonic examinations: organic or functional?". J. Clin. Gastroenterol. 13 (5): 531–6. PMID 1744388.
- ↑ Read N, Krejs G, Read M, Santa Ana C, Morawski S, Fordtran J (1980). "Chronic diarrhea of unknown origin". Gastroenterology. 78 (2): 264–71. PMID 7350049.
- ↑ Thomas P, Forbes A, Green J, Howdle P, Long R, Playford R, Sheridan M, Stevens R, Valori R, Walters J, Addison G, Hill P, Brydon G (2003). "Guidelines for the investigation of chronic diarrhoea, 2nd edition". Gut. 52 Suppl 5: v1–15. PMID 12801941.[1].