Initial laboratory and imaging evaluation for poor weight gain in children younger than 2 years in resource-abundant countries

Test(s)	Rationale
Basic tests (performed in most children)
CBC, CRP, ESR	Screen for anemia, chronic infection, inflammation, malignancy
tTg-IgA and total IgA^*	Screen for celiac disease
Urinalysis, urine culture	Screen for protein or carbohydrate loss (eg, glucosuria) and indolent kidney disease (eg, renal tubular acidosis, UTI)
Additional tests for initial evaluation if clinically indicated by the history or examination
Iron panel, lead level Electrolytes, BUN, creatinine, glucose Calcium, phosphorus, magnesium Albumin, total protein, liver enzymes Amylase, lipase Transthyretin (prealbumin)^¶	Evaluation of kidney, liver, and pancreatic disease Assessment of nutritional status
Stool studies: Guaiac, calprotectin (or leukocytes) Routine culture, ova and parasite smears Giardia antigen	Evaluate gastrointestinal infection (eg, for bloody stools and/or diarrhea)
Chest radiograph	Evaluate cardiopulmonary disease

BUN: blood urea nitrogen; CBC: complete blood count; CRP: C-reactive protein; ESR: erythrocyte sedimentation rate; IgA: immunoglobulin A; tTg-IgA: tissue transglutaminase-immunoglobulin A antibody; UTI: urinary tract infection.

* Celiac disease screening is only relevant if the diet includes gluten (any foods with wheat, barley, or rye).

¶ Transthyretin (prealbumin) and albumin are surrogate markers of the adequacy of the diet over the short and long terms, respectively. Transthyretin measurements are not useful in the routine evaluation of nutritional status, but they may be helpful in the evaluation of selected patients whose nutritional status is unclear after a global assessment to determine the adequacy of their recent dietary intake.

Graphic 134406 Version 3.0

خرید پکیج

Initial laboratory and imaging evaluation for poor weight gain in children younger than 2 years in resource-abundant countries