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Unexplained weight loss

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Unexplained weight loss

  1. 1. UNEXPLAINED WEIGHT LOSS
  2. 2. 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+
  3. 3. 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
  4. 4. Chest: B/L clear air entry CVS:S1.S2.M0 P/A:Soft tenderness around Right Hypochondriac Region+ Hepatomegaly+
  5. 5. 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
  6. 6. INVESTIGATION
  7. 7.  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
  8. 8. BONE MARROW ASPIRATION
  9. 9. SEROLOGY
  10. 10. SEROLOGY
  11. 11. THYROID FUNCTION TEST
  12. 12. CT Scan Report
  13. 13. USG REPORT
  14. 14. DIAGNOSIS  Iron Deficiency Anemia Abdominal Pain(?Cause) Weight Loss(?Cause)
  15. 15. TREATMENT
  16. 16. LITERATURE
  17. 17. Body Mass Index
  18. 18. 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
  19. 19. 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?
  20. 20. 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
  21. 21. REFERENCE www.mayoclinic.org Harrison’s Principle of Internal Medicine wikipedia
  22. 22. THANK YOU

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