1. Literature Review
• Each 5% unintentionally loss of body weight
within 6-12 months need further concern.
• It gives sign of underlying systemic disease
• i.e. In fluid composition/volume changing
body weight might change rapidly within days.
• the body weight loss because of neoplasm
would take a longer time.
• deep historical taking and examination should
be done to confirm the etiology

2. Given Question
• change in belt notch size
• the fit of clothing
• history of GI problems
• risk of HIV
• risk of malignancy
• signs of depression
• Prolonged infection
• Etc.

3. Possible etiologies of weight loss
(2009, Fauci et.al)
Cancer Medications :A
Endocrine & metabolic causes Mouth & teeth disorders
GI disorders Age-related Factors
- Physiologic changes
- Decreased taste & smell
- Functional disabilities
Cardiac disorders
- Chronic Ischemia
- Chronic congestive heart failure
Neurologic causes
Respiratory disorders
- Emphysema
- Chronic obstructive pulmonary disease
Social causes
- Isolation
- Economic hardship
Renal insufficiency Psychiatric & behavioral
Rheumatologic disease Idiopathic
Infections
- HIV -Tuberculosis

4. Weight-loss in TB patient
• Malnutrition is one of important risk factor for TB
development
• malnutrition affect cell-mediated immunity that works
as the principle host against TB.
• TB itself could lead the patient into malnutrition
condition
• In TB patient  found a significant reduction in BMI,
triceps skinfold thickness, arm muscle circumference,
serum albumin, iron, and total iron binding capacity 
lead to immunosupressed condition
• Adequate treatment & nutrition support needed

5. • References:
• Fauchi AS, et.al (ed.). Harrison’s manual of
medicine. 17th ed. New York: McGraw-Hill; 2009.
p.247-8
• Cegielski JP, McMurray DN. The relationship
between malnutrition and tuberculosis: evidence
from studies in humans and experimental
animals.Int J Tuberc Lung Dis 2004;8:286–298.
• Onwubalili JK. Malnutrition among tuberculosis
patients in Harrow, England. Eur J Clin
Nutr 1988;42:363–366.