MANUAL OF CLINICAL DIAGNOSIS
Involuntary weight loss over weeks or months is a concerning symptom that may indicate a wide range of underlying medical conditions, both physical and psychological. This weight loss is generally defined as a reduction of 5% or more of body weight over a period of 6 to 12 months without changes in diet or physical activity. Identifying the cause of weight loss is crucial to provide appropriate treatment and prevent further complications.
Pathology | Clinical Symptoms and Signs | Suspected Diagnosis | Confirmatory Diagnosis |
Advanced Neoplasia | Weight loss, fatigue, localized pain, palpable masses, night sweats | Medical history, physical examination, family history | Chest X-ray, computed tomography (CT), biopsy, tumour markers |
Psychiatric Disorders | Weight loss, changes in appetite, mood disorders, anxiety, social withdrawal | Medical history, psychiatric evaluation | Clinical interview, assessment questionnaires, depression and anxiety scales |
Gastric Pathology | Weight loss, abdominal pain, dyspepsia, vomiting, changes in bowel habits | Medical history, physical examination, gastrointestinal history | Upper endoscopy, abdominal CT, liver function tests |
Alcoholism | Weight loss, excessive alcohol consumption, hepatomegaly, jaundice, peripheral neuropathy | History of alcohol use, physical examination | Liver function tests, liver ultrasound, blood alcohol levels |
Undiagnosed Diabetes Mellitus | Weight loss, polydipsia, polyuria, polyphagia, fatigue, blurred vision | Medical history, physical examination, symptoms of hyperglycaemia | Fasting blood glucose, HbA1c, glucose tolerance test |
Thyrotoxicosis | Weight loss, nervousness, tremors, palpitations, heat intolerance, exophthalmos | Medical history, physical examination, hyperthyroid symptoms | Thyroid function tests (TSH, free T4, T3), thyroid scan |
Pulmonary Tuberculosis | Weight loss, persistent cough, haemoptysis, fever, night sweats | Medical history, physical examination, exposure history | Chest X-ray, tuberculin skin test, sputum culture |
Addison’s Disease | Weight loss, fatigue, hyperpigmentation, hypotension, nausea | Medical history, physical examination, adrenal insufficiency symptoms | ACTH stimulation test, cortisol and ACTH levels |
Other Causes | Symptoms vary according to underlying pathology | Medical history, physical examination | Specific tests according to clinical suspicion |
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