5minpediatrics

5minpediatrics Simplifying Pediatrics in 5 Minutes!

By Dr. Amit Kumar (MBBS, DCH, DNB Peds)
đź“š Daily case-based tips, clinical quizzes & visual learning for students, residents & doctors.
🎯 Follow for sharp, short & smart pediatric updates!

07/12/2025

Best test to diagnose malabsorption syndrome

Specific Tests for Malabsorption Syndrome
07/12/2025

Specific Tests for Malabsorption Syndrome

A 7-year-old boy is brought with progressive swelling of the legs, abdominal distension, and chronic intermittent diarrh...
07/12/2025

A 7-year-old boy is brought with progressive swelling of the legs, abdominal distension, and chronic intermittent diarrhea for the past 5 months. Parents report that he becomes easily fatigued and has poor weight gain despite a good appetite.
History reveals:
Stools occasionally bulky but not foul-smelling
No vomiting, no blood in stools
No recurrent infections or respiratory problems
No cardiac symptoms
On physical examination:
Bilateral pitting pedal edema
Mild periorbital puffiness
Protuberant abdomen with ascites
No hepatosplenomegaly
No lymphadenopathy
Growth parameters are below the 10th percentile
Investigations:
Hemoglobin: 10 g/dL
Serum albumin: 1.8 g/dL (markedly low)
Total protein: 4.5 g/dL
Urine: no proteinuria
Liver function: normal
Stool α-1 antitrypsin clearance: markedly elevated
Lymphocyte count: low (lymphopenia)
Stool fat: mildly increased
Echocardiography: normal
Ultrasound abdomen: mild ascites, normal liver
An upper GI endoscopy shows white, enlarged mucosal folds in the duodenum described as a “snowflake” or “frosted glass” appearance.
Q. What is the most likely diagnosis, and what mechanism explains the child’s edema and low albumin?

A 12-year-old girl is brought with a 3-month history of abdominal pain and bloody diarrhea. The episodes occur 6–8 times...
06/12/2025

A 12-year-old girl is brought with a 3-month history of abdominal pain and bloody diarrhea. The episodes occur 6–8 times per day, often urgent, with tenesmus and passage of mucus. Parents report that the child has become increasingly weak and fatigued.
She has no weight loss initially, but over the last month her appetite has reduced. There is no history of perianal pain, fissures, or ulcers. No skin rashes, arthritis, or eye symptoms.
On examination:
Pale, mildly dehydrated
Mild left lower quadrant abdominal tenderness
No organomegaly
No perianal disease
Growth parameters: normal for age
Initial Investigations:
Hemoglobin: 9.2 g/dL
ESR: 52 mm/hr
CRP: moderately elevated
Serum albumin: 3.4 g/dL (mildly low)
Stool calprotectin: markedly elevated
Stool culture: negative
Anti-TTG IgA: negative
pANCA: positive
Parents are worried because the bleeding has been consistent and increasing.
Q. Based on the clinical picture and lab findings, what is the most likely diagnosis, and which test would BEST help confirm it?

14-year-old boy is brought by his parents with a 6-month history of intermittent abdominal pain, reduced appetite, and p...
05/12/2025

14-year-old boy is brought by his parents with a 6-month history of intermittent abdominal pain, reduced appetite, and progressive weight loss. His mother reports that the pain is mostly in the right lower quadrant, worsens after meals, and sometimes wakes him at night.
He has 3–4 episodes of diarrhea daily, occasionally mixed with mucus but rarely with visible blood. The parents note that he has become more tired and looks pale.
On examination:
Height and weight are both below the 5th percentile for age (previously at 25th percentile).
Oral aphthous ulcers present
Abdomen: mild distension, tenderness in the right iliac fossa, no organomegaly
Perianal area shows a small skin tag
No arthritis or rash
Initial Investigations:
Hemoglobin: 9 g/dL
ESR: 48 mm/hr
CRP: elevated
Serum albumin: 3.0 g/dL
Stool calprotectin: markedly elevated
Stool culture: negative
Anti-TTG IgA: negative
Q. Based on the clinical picture and investigations, what is the most likely diagnosis, and which test would BEST help confirm it?

A previously healthy 1-year-old had severe gastroenteritis 2 months ago. Since then, he has persistent diarrhea, vomitin...
04/12/2025

A previously healthy 1-year-old had severe gastroenteritis 2 months ago. Since then, he has persistent diarrhea, vomiting, and inability to tolerate cow’s milk or wheat diet. He has poor appetite and weight loss.
Investigations:
Stool pH: 4.5
Reducing substances: strongly positive
Stool fat: mildly increased
Anti-TTG IgA: negative
D-xylose absorption test: very low
Question:
What is the diagnosis, and which physiological change explains the combination of fat and carbohydrate malabsorption?

1-year-old child presents with explosive watery diarrhea, foul-smelling stools, distension, and weight loss. The child a...
03/12/2025

1-year-old child presents with explosive watery diarrhea, foul-smelling stools, distension, and weight loss. The child attends day-care and frequently puts toys/objects in mouth.
Investigations:
Stool: fat droplets + cysts of Giardia lamblia
Reducing substances positive
Stool pH: 5.2
NO anemia
Hydration normal
Question:
What is the most likely cause of malabsorption in this case, and what is the treatment of choice?

1-year-old boy presents with generalized swelling, recurrent diarrhea, and failure to thrive. There is no nephrotic-rang...
03/12/2025

1-year-old boy presents with generalized swelling, recurrent diarrhea, and failure to thrive. There is no nephrotic-range proteinuria. On exam, the child has wasting with bilateral pedal edema.
Investigations:
Serum albumin: 1.8 g/dL
Total protein: very low
Stool: Alpha-1 antitrypsin: markedly elevated
Stool fat: normal
Stool reducing substances: negative
Question:
What is the likely diagnosis and which mechanism explains the low serum albumin?

13-month-old child, recently weaned onto wheat-based foods, has chronic diarrhea, abdominal distension, irritable behavi...
02/12/2025

13-month-old child, recently weaned onto wheat-based foods, has chronic diarrhea, abdominal distension, irritable behavior, and buttock wasting
Parents report that the child refuses feeds and seems “too quiet.”
Findings:
Hemoglobin: 8.5 g/dL (microcytic)
Anti-TTG IgA: strongly positive
Total IgA: normal
Stool: fat globules present, no reducing substances

Question:
What is the most likely diagnosis, and what is the definitive test to confirm it?

A 1-year-old girl presents with poor weight gain, recurrent greasy, oily, foul-smelling stools, and repeated hospital vi...
02/12/2025

A 1-year-old girl presents with poor weight gain, recurrent greasy, oily, foul-smelling stools, and repeated hospital visits for cough with wheeze. On examination, she is underweight with digital clubbing.
Investigations:
Chest X-ray: hyperinflated lungs
Stool: massive steatorrhea, no reducing substances
Serum sodium & chloride: normal
Sweat chloride: borderline
F***l elastase: very low
Question:
What is the most likely diagnosis and which test is the gold standard to confirm pancreatic insufficiency?

A 1-year-old boy is brought with persistent diarrhea for 6 weeks. The stools are pale, bulky, foul-smelling, and difficu...
01/12/2025

A 1-year-old boy is brought with persistent diarrhea for 6 weeks. The stools are pale, bulky, foul-smelling, and difficult to flush. Parents report poor weight gain, irritability, and abdominal distension. On examination, the child is underweight, has visible muscle wasting, and a protuberant abdomen.
Vitals are stable.
Key labs:
Hemoglobin: 9.5 g/dL
Serum albumin: 2.8 g/dL
Stool analysis: positive for reducing substances, fat globules present, pH 5
Anti-TTG IgA: normal
Sweat chloride test: normal
Stool for ova/cysts: negative
âť“ Question
What is the most likely cause of malabsorption in this child, and which additional test would best help confirm the diagnosis?
Did you follow 5minpediatrics?

29/11/2025

Treatment and identification of scabies

Address

Patna
100027

Telephone

+918789716855

Website

https://masterpediatrics.com/, http://www.pranmitfoundation.in/

Alerts

Be the first to know and let us send you an email when 5minpediatrics posts news and promotions. Your email address will not be used for any other purpose, and you can unsubscribe at any time.

Contact The Practice

Send a message to 5minpediatrics:

Shortcuts

Share

Share on Facebook Share on Twitter Share on LinkedIn
Share on Pinterest Share on Reddit Share via Email
Share on WhatsApp Share on Instagram Share on Telegram

Category