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Differential Diagnosis for Weight Loss in a 2-Year-Old

Single Most Likely Diagnosis

  • Inadequate Nutrition: This is often the most common reason for weight loss in toddlers, due to insufficient caloric intake or inadequate dietary quality. Toddlers have high energy needs for growth and development, and if their diet does not meet these needs, they can lose weight.

Other Likely Diagnoses

  • Gastroesophageal Reflux Disease (GERD): GERD can lead to feeding difficulties and refusal, resulting in inadequate nutrition and weight loss.
  • Food Allergies or Intolerances: Allergies to common foods like milk, eggs, or wheat can cause gastrointestinal symptoms, leading to poor feeding and weight loss.
  • Infections: Chronic or recurrent infections, such as urinary tract infections or gastrointestinal infections, can cause weight loss due to increased metabolic demands and decreased appetite.
  • Developmental Delays or Feeding Disorders: Conditions like autism spectrum disorder or oral motor disorders can lead to feeding difficulties and weight loss.

Do Not Miss Diagnoses

  • Type 1 Diabetes: Although less common, type 1 diabetes can present with weight loss, polyuria, and polydipsia. Early diagnosis is crucial to prevent diabetic ketoacidosis.
  • Celiac Disease: An autoimmune reaction to gluten can cause malabsorption, leading to weight loss and other gastrointestinal symptoms.
  • Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause chronic inflammation, leading to malabsorption and weight loss.
  • Tumor or Cancer: Although rare, tumors or cancer can cause weight loss in children, often accompanied by other symptoms like fever, fatigue, or abdominal masses.

Rare Diagnoses

  • Congenital Heart Disease: Certain congenital heart defects can lead to increased metabolic demands and decreased feeding, resulting in weight loss.
  • Endocrine Disorders: Conditions like hypothyroidism or adrenal insufficiency can cause weight loss, although these are relatively rare in toddlers.
  • Genetic Disorders: Certain genetic conditions, such as cystic fibrosis or muscular dystrophy, can be associated with weight loss and failure to thrive.
  • Immunodeficiency: Primary immunodeficiencies can increase the risk of infections, leading to weight loss and other complications.

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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