Literature Review

• Each 5% unintentionally loss of body weight within 6-12 months need further concern.

• It gives sign of underlying systemic disease• i.e. In fluid composition/volume changing body

weight might change rapidly within days. • the body weight loss because of neoplasm

would take a longer time. • deep historical taking and examination should

be done to confirm the etiology

Given Question

• change in belt notch size• the fit of clothing• history of GI problems• risk of HIV• risk of malignancy• signs of depression• Prolonged infection• Etc.

Possible etiologies of weight loss (2009, Fauci et.al)

Cancer Medications :AEndocrine & metabolic causes Mouth & teeth disordersGI disorders Age-related Factors

- Physiologic changes- Decreased taste & smell- Functional disabilities

Cardiac disorders- Chronic Ischemia- Chronic congestive heart failure

Neurologic causes

Respiratory disorders- Emphysema- Chronic obstructive pulmonary disease

Social causes- Isolation- Economic hardship

Renal insufficiency Psychiatric & behavioralRheumatologic disease IdiopathicInfections- HIV -Tuberculosis

Weight-loss in TB patient

• Malnutrition is one of important risk factor for TB development

• malnutrition affect cell-mediated immunity that works as the principle host against TB.

• TB itself could lead the patient into malnutrition condition• In TB patient found a significant reduction in BMI,

triceps skinfold thickness, arm muscle circumference, serum albumin, iron, and total iron binding capacity lead to immunosupressed condition

• Adequate treatment & nutrition support needed

• References:• Fauchi AS, et.al (ed.). Harrison’s manual of medicine.

17th ed. New York: McGraw-Hill; 2009. p.247-8 • Cegielski JP, McMurray DN. The relationship between

malnutrition and tuberculosis: evidence from studies in humans and experimental animals.Int J Tuberc Lung Dis 2004;8:286–298.

• Onwubalili JK. Malnutrition among tuberculosis patients in Harrow, England. Eur J Clin Nutr 1988;42:363–366.