What is the differential diagnosis for a 15-year-old (fifteen-year-old) teenager presenting with vomiting and weight loss?

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Differential Diagnosis for 15yo Teen with Vomiting and Weight Loss

Single Most Likely Diagnosis

  • Anorexia Nervosa: This is a common condition in teenagers, especially females, characterized by a distorted body image, fear of gaining weight, and restrictive eating patterns, leading to significant weight loss and potentially vomiting.

Other Likely Diagnoses

  • Gastroesophageal Reflux Disease (GERD): GERD can cause vomiting, especially after eating, and if severe, can lead to weight loss due to decreased intake.
  • Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis can cause chronic vomiting and weight loss due to malabsorption and decreased appetite.
  • Gastritis: Inflammation of the stomach lining can cause vomiting and weight loss if the condition leads to a decrease in food intake.
  • Food Intolerance or Allergy: Lactose intolerance, celiac disease, or other food allergies can cause gastrointestinal symptoms including vomiting and weight loss if the offending food is not avoided.

Do Not Miss Diagnoses

  • Diabetic Ketoacidosis: Although less common in the context of weight loss and vomiting without other symptoms like polyuria and polydipsia, it's crucial to consider, especially if there's a family history of diabetes.
  • Thyroid Disorders: Hyperthyroidism can cause weight loss and vomiting, among other symptoms, and is critical to diagnose due to its impact on metabolism and overall health.
  • Addison's Disease: This rare endocrine disorder can cause weight loss, vomiting, and other systemic symptoms, and is life-threatening if not treated.
  • Cancer: Although rare in teenagers, certain types of cancer (like brain tumors or leukemia) can present with non-specific symptoms including weight loss and vomiting.

Rare Diagnoses

  • Cystic Fibrosis: A genetic disorder that can cause malabsorption leading to weight loss and gastrointestinal symptoms, including vomiting.
  • Eosinophilic Esophagitis: An allergic condition causing inflammation of the esophagus, which can lead to vomiting and difficulty swallowing.
  • Mitochondrial Disorders: A group of disorders affecting the mitochondria, which can cause a wide range of symptoms including vomiting and weight loss due to muscle and gastrointestinal involvement.
  • Whipple's Disease: A rare bacterial infection causing malabsorption, weight loss, and gastrointestinal symptoms.

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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