Investigations
1st investigations to order
according to clinical assessment
Test
Investigations should be driven by findings from the clinical assessment.
Result
references and guidelines cited suggest a range of additional tests for consideration, and local guidelines will also guide testing
FBC
Test
To test for anaemia.
Result
low haemoglobin or haematocrit may indicate anaemia
iron studies
Test
Iron deficiency is common in children with poor growth.
Result
low ferritin
chemistry panel
Test
Enables assessment of renal tubular acidosis, or monitoring of refeeding syndrome, if indicated.
Result
variable
urinalysis
Test
If there is concern for infection, glycosuria, or renal pathology.
Result
variable
Investigations to consider
blood lead level
Test
To investigate lead poisoning if locally prevalent.
Result
>0.4 micromol/L (>5 microgram/dL) indicates poisoning
serological testing for coeliac disease
Test
Order a total immunoglobulin-A (IgA) and immunoglobulin A-tissue transglutaminase (IgA-tTG) test in any patient with suspected coeliac disease.[36]
Higher titres have increased positive predictive value. Serological testing should be done on a gluten-containing diet.
For young children (around 2 years or below), deamidated gliadin IgA and IgG antibodies should also be included.
Result
titre above normal range for laboratory. Valid only if the patient is consuming a gluten-containing diet
stool analysis
Test
For infection or malabsorption depending on symptoms and travel history.
Result
variable
HIV testing or other infectious screen
Test
If indicated by history or physical examination.
Result
positive test result
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