Sandbox: malabsorption

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Abbreviations: WBC: White blood cells; Plt: Platelets, Hgb: Hemoglobin, IgE: Immunoglobulin E, IgA: Immunoglobulin A

Cause Peak age of onset History Physical exam Lab findings Additional findings Cause/Pathogenesis Gold standard diagnosis
Fever Abdominal pain Diarrhea Weight loss
Watery Fatty WBC Hgb Plt Other lab findings
Whipple's disease 40-60 +/- + + + + ↓/↑
Celiac disease Childhood

Adult

- + +/- +/- + - -
  • IgA endomysial antibody
  • Anti-tissue transglutaminase antibody
  • Anti-gliadin antibody
  • IgA endomysial antibody
  • IgA tissue transglutaminase antibody
Cystic fibrosis Childhood

Adult

+ + - + +
  • Positive DNA analysis for CFTR multimutation method
  • Evaluated nasal transepithelial potential difference (NPD)
Crohns disease Young adults

(20th)

+ + + + +
  • Abnormal immune response to self antigens
Irritable bowel syndrome 30-50 - +/- +/- +/- - - - -
  • Diagnosis of exclusion
VIPoma 30-50 - + + + +
  • Primary secretory tumor
  • Elevated VIP levels
  • Followed by imaging
Zollinger-Ellison syndrome) 20-50
  • Elevated basal or stimulated serum gastrin> 1000 pg/mL
Lactose intolerance Any age +
Allergic enteropathy/Food protein-induced enterocolitis syndrome (FPIES) Infancy + - +/- + Stool examination:
  • Triggered by cow milk protein
  • Profuse, repetitive vomiting
  • Oral food challenge (OFC)
Eosinophilic gastroenteritis  30th + - +/- +
Primary bile acid malabsorption Childhood Adolescents + +/- + +/- -
Abetalipoproteinemia Infancy - + + +
Microscopic colitis 60th + - + +
Hyperthyroidism Any age + - + +/-
  • Elevated T4
  • Elevated T3
  • Decreased level of TSH
Grain allergy Childhood - + + - +