UNEXPLAINED WEIGHT LOSS

27 year old female presented with:

C/O: Upper abdominal Pain(on/off) x 6

month Occasionally nausea,vomiting Shortness of Breath on exertion+ Menorrhagia+

ON EXAMINATION

General Condition: Malnourished+, Body Mass Index(BMI)=14.06 Jaundice:Nil Anemic :Mild LN:Nil Cyanosis:Nil Clubbing:Nil Oedema:Nil Dehydration:Nil VITALS: P:80/min BP:80/40mmHg R/R:20/min T:afebrile

Chest: B/L clear air entry CVS:S1.S2.M0

P/A:Soft tenderness around Right Hypochondriac Region+ Hepatomegaly+

MEDICAL h/o: no h/o DM,HTN,PTB,Hepatitis

SURGICAL h/o:Appendicectomy done last

year, 2 C.S Performed

ALLERGIC h/o:non significant

PERSONAL h/o:Non Significant

INVESTIGATION

COMPLETE BLOOD COUNT: WBC:14.28X10*9/L(N=72.9%),L(17.1%), RBC:3.34X10*12/L,HB:76g/L,HCT:25.6%,MCV:76.6fl,RET%:2.5% PLT:631X10*9/L

Tumor Marker:CA 125,CA 19-9,AFP,CEA =all are Normal

Renal Function Test: Within Normal Limits

Biochemistry: Gluc=5.87mmol/L, Amylase:370U/L,Ca:2.12mmol/L Albumin:29.2g/L,ESR:100mm/hr,CRP:125.89mg/L

Liver Function Test: Within Normal Limits

URINE R/E,STOOL R/E:Normal Findings

BONE MARROW ASPIRATION

SEROLOGY

SEROLOGY

THYROID FUNCTION TEST

CT Scan Report

USG REPORT

DIAGNOSIS

Iron Deficiency Anemia

Abdominal Pain(?Cause)

Weight Loss(?Cause)

TREATMENT

LITERATURE

Body Mass Index

Etiology Of Weight Loss

Addison’s Disease Cancer HIV/AIDS Tuberculosis Celiac Disease Crohn's Disease DM Hyperthyroidism COPD Heart Failure Peptic Ulcer Parkinson’s Disease

DISCUSSION

BMI is only 14.06 suggests passing is severely malnourished,albumin is also low so is transfusion of albumin and Nutrients rich diet is must for management?

Addison’s Disease is the leading cause of wieght loss, did we evaluated it?

Low Hb,elevated Platelets,raised ESR,CRP and WBC with abdominal pain is highly suggestive of

Ulcerative Colitis & Crohn’s Disease?

What may be the likely cause of Iron Deficiency Anemia in this patient?

Further Investigations Probably Needed

Endoscopy,Colonoscopy to rule out Ulcerative Colitis ,Crohn’s Disease?

Contrast Enhanced CT for more proper visualization?

Laparascopic evaluation of abdomen

REFERENCE

www.mayoclinic.orgHarrison’s Principle of Internal Medicinewikipedia

THANK YOU