Premium
Diagnostic Workup and Micronutrient Deficiencies in Children With Failure to Thrive Without Underlying Diseases
Author(s) -
Selbuz Suna,
Kırsaçlıoğlu Ceyda Tuna,
Kuloğlu Zarife,
Yılmaz Mustafa,
Penezoğlu Nilay,
Sayıcı Ufuk,
Altuntaş Cansu,
Kansu Aydan
Publication year - 2019
Publication title -
nutrition in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.725
H-Index - 71
eISSN - 1941-2452
pISSN - 0884-5336
DOI - 10.1002/ncp.10229
Subject(s) - medicine , failure to thrive , malnutrition , pediatrics , micronutrient , etiology , micronutrient deficiency , outpatient clinic , weight for age , retrospective cohort study , pathology
Objectives and study Failure to thrive (FTT) is an interruption in the normal pattern of growth. We aimed to evaluate the clinical characteristics, underlying etiologies, diagnostic workup, and frequency of micronutrient deficiencies (MDs) in children with FTT. Methods This retrospective study was done with 729 children (319 male, mean age 6.8 ± 5.5 years) with FTT (weight for age <3rd percentile) who had visited the Pediatric Gastroenterology outpatient clinic between 2011 and 2016. Children who had previously known chronic diseases, inadequate intake, or inadequate absorption were excluded. Acute malnutrition was considered if weight‐for‐age z ‐scores were below −2 and height‐for‐age z ‐scores were above −2, and chronic malnutrition was defined if height‐for‐age z ‐scores were below −2. Results The malnutrition rate was 57.1% (acute: 37.8%, chronic: 19.3%). Of children, 98.7% had laboratory evaluation. We found that 1.1% of laboratory tests, 0.4% of imaging studies, 27% of endoscopic findings, and biopsy results led to a specific diagnosis, equating to a total of 1.3% of diagnostic workup leading to a diagnosis related to FTT. The causes of FTT were inadequate nutrition (61.4%), psychiatric and behavioral disorders (17.2%), endocrinologic disorders (9%), recurrent infections (6.4%), gastrointestinal diseases (1.9%), and cardiac disorders (0.1%). Vitamin A and D deficiencies were the most common MD. Conclusion We showed that the most common cause of FTT is “purely nutrition” FFT because of inadequate caloric intake, and extensive diagnostic workup is rarely helpful to reveal the etiology. These results implicate the importance of clinical evaluation and anthropometry to evaluate a child with FTT.