Adam “I’m from New York not New Jersey” Schoenfeld discussed a case of unintentional weight loss in a patient w/ many GI complaints today. Our discussions focused mainly on the workup of unintentional weight loss. I’ve attached the link for an AAFP review article that breaks it down nicely, however for a quick hitter I’ll give you goop’s approach:
-Think like a geriatrician.Our minds tend to jump to TB and malignancy, but much more common things like poor access to food, inadequate dentition, esophageal and pharyngeal dysphagia, dysgeusia, all are big contributors to weight loss.
-After those common things, consider malabsorption, and then once that is ruled out consider occult infection or malignancy
Reasonable at that point to send an ESR/CRP, here’s your #LTPearl for the week:
-Reasonable to check inflammatory markers, and if elevated to consider a temporal artery biopsy and/or CT aortogram to assess for large vessel vasculitis