Thin

Introduction Weight loss refers to the body's weight loss due to disease or certain factors, body fat and protein decreased, less than 10% of the standard weight is weight loss (the author believes that those who are 10% lower than the standard weight are lean, Less than 20% is called weight loss). The weight loss referred to here is generally positive in the short term. There is a comparison of the weight values measured before and after the weight loss, and there are obvious clothes loose, the belt becomes loose, the shoes become larger and the subcutaneous fat is reduced, the muscles are thin, and the skin is slack. , bones stand out and other circumstantial evidence. As for the weight loss after dehydration and edema subsided, it cannot be called weight loss.

Cause

What are the causes of weight loss?

1, from a pathological point of view, digestive diseases, diabetes, hyperthyroidism, hepatitis, kidney disease and many other diseases can cause body weight loss. Long-term illness and physical weakness, malnutrition can also cause weight loss.

2, physical, genetic factors, some body weight loss, to the hospital for examination did not find any disease, normal work on weekdays, the body basically no discomfort. The weight loss of these people may be related to physical and genetic factors. For example, the parents are thin and the children are mostly thin.

3, the factors of life and eating habits: a large part of the thinners are caused by unreasonable diet and living habits. Insufficient diet, unreasonable diet, irregular meals, stressful work, anxiety, nervousness, excessive fatigue, poor sleep, etc. can lead to weight loss.

an examination

Related inspection

Plasma thrombomodulin antigen detection serum albumin (ALB, A) Keratin 19 fragment (CYFRA21-1) Upper gastrointestinal function assay and imaging keratin 19 fragment (CYFRA21-1)

First, medical history

(1) Genetic and family history

Physical weight loss often has a family history without pathological manifestations. Hyperthyroidism, diabetes, and pheochromocytoma (multiple endocrine neoplasia syndrome) often have a family history. Some malignant tumors have a family history.

(2) Economic conditions and eating habits

Such as whether the heat intake is sufficient, whether there is enough protein, whether it is a partial eclipse or a foreign food, whether there are raw fish, shrimps and crabs, raw vegetables, raw beef and mutton habits, such as raw water, Hongling, Liyang, sorghum and other aquatic plants. Can cause ginger schistosomiasis, parasitic in the small intestine, causing diarrhea, digestive dysfunction, malnutrition. Raw food or edible uncooked fish, shrimp, crab, etc. can be infected with clonorchiasis, raw crab or smoke and infection with paragonimiasis. Raw or edible uncooked beef and pork can be infected with tsutsugamushi. Consumption of vegetables, fruits and fruits with parasite eggs, drinking water, such as cysticercosis, cysticercosis, ascariasis, etc., can cause weight loss.

(3) Birthplace, occupation

There are more paddy fields in southern China, and farmers or fishermen are repeatedly exposed to the contaminated water contaminated by schistosomiasis and infected with schistosomiasis. In pastoral areas, cattle, sheep and livestock houses may be infected with cysticercosis and cysticercosis. Hookworm disease and tsutsugamushi disease are more common in rural areas, and may be thin when severely infected.

(4) Other medical history

Ask about the history of sexual contact, the history of male homosexuality, whether there is drug abuse or the history of anesthesia, and the use of unclean or shared needles to spread AIDS, that is, to infect human immunodeficiency virus.

(5) Pay attention to the age of onset of the wasted person and ask about the accompanying symptoms

1. Weight loss with appetite hyperthyroidism: should consider whether there is hyperthyroidism, diabetes, pheochromocytoma.

2. Adolescent weight loss, such as fever, night sweats, swollen lymph nodes, cough, should be excluded from tuberculosis; if accompanied by short stature. Hepatosplenomegaly, those who have been to schistosomiasis endemic areas should be excluded from schistosomiasis or other parasitic diseases.

3. Those who suffer from gastrointestinal symptoms such as loss of appetite, nausea, vomiting, diarrhea or difficulty swallowing should be excluded from digestive tract diseases.

4. Women should be asked about menstrual history, birth history, history of postpartum hemorrhage, if there is a history of weight loss, amenorrhea, postpartum hemorrhage, Xihan syndrome should be considered.

5. Weight loss with long-term fever: should consider tuberculosis, chronic suppurative infections such as liver abscess, infectious diseases, connective tissue disease. Malignant tumors, especially malignant tumors of liver, lung and kidney, leukemia, lymphoma, malignant histiocytosis, etc. may have long-term fever, but often have weight loss, fatigue, and loss of appetite.

Second, physical examination

(1) Weight measurement

It should be done regularly and compared with the standard weight to understand whether the weight loss is progressive, and the common diseases that cause weight loss are diabetes, hyperthyroidism, malignant tumors, etc.

(B) detailed physical examination can often prompt early diagnosis clues.

1. For the thinners, the body temperature and blood pressure should be measured. For those with long-term fever, chronic infection, tumor, connective tissue disease, hyperthyroidism, and pheochromocytoma may be considered. Patients with hypertension (paroxysmal or persistent) should consider pheochromocytoma.

2. Check the mouth, skin, hair, lymph nodes, etc.: pay attention to whether there is malnutrition, vitamin deficiency, anemia, edema, etc. The anterior pituitary dysfunction in patients with skin pigmentation, hair loss, pubic hair is more obvious, the skin is pale, dry, dull and genital atrophy, women have breast atrophy. Adison patients have skin pigmentation, lip and oral membranes are a little flaky blue-black pigmentation, and the skin is more exposed to exposed areas, pressure and friction parts, early dizziness, perineum, and abdominal white lines. Patients with hyperthyroidism have warm, moist and sweaty skin, tremors when the tongue and hands are stretched out, heart rate is accelerated, heart sounds are hyperthyroidism, etc., and signs such as goiter and exophthalmos may be present. Patients with carcinoid syndrome may have paroxysmal asthma, skin flushing, right heart valve murmur and hepatomegaly. Skin purple spots, swollen lymph nodes, etc. should consider blood diseases and malignant tumors.

3. Examination of other systems: examinations such as chest, abdomen and nervous system are important clues for early diagnosis.

Third, buy a laboratory inspection

(1) Blood, urine, and feces routine

1. Abnormal blood routine to blood diseases, tumors, and chronic infections. The diagnosis of malnutrition is helpful.

2. Urine routine and urine relative density test can help early diagnosis of renal disease.

3. Examination of fecal routine and occult blood for intestinal inflammation and tumors. The diagnosis of parasitic diseases is helpful.

(B) ESR increases often indicate the presence of tuberculosis, tumors, connective tissue diseases and various chronic infections.

Fourth, equipment inspection

1. X-ray examination: Skull (sella) chest X-ray, barium meal, barium enema and other tests for the diagnosis of tuberculous tumors and digestive tract lesions.

2. B-type ultrasound, endoscopy, radionuclide scanning, CT, MRI, SPECT, etc. are important for diseases such as tuberculosis and malignant tumors that cause weight loss.

Differential diagnosis

The wasting weight loss refers to the performance of weight loss due to a wasting disease, which can be found in tuberculosis, diabetes, hyperthyroidism, and the like. Systemic weight loss refers to the body's weight loss due to disease or certain factors, common in neuroendocrine and metabolic diseases, malignant tumors, chronic infections, digestive tract diseases, anorexia nervosa (nervous anorexia), severe trauma and burns.

Simple weight loss includes constitutional wasting and exogenous wasting. Institutional wasting is mainly non-gradual weight loss and has certain heritability. Exogenous wasting is usually affected by various factors such as diet, lifestyle and psychology. Insufficient food intake, partial eclipse, anorexia, missing meals, irregular life and lack of exercise, eating habits and work stress, mental stress and excessive fatigue are the causes of exogenous wasting. Simple upper body weight loss is a manifestation of progressive lipodystrophy. Progressive lipodystrophy is a rare autonomic nervous system disorder characterized by adipose tissue metabolic disorders. The clinical and histological features are slowly progressive bilateral distribution with substantially symmetrical, well-defined, subcutaneous adipose tissue atrophy or Disappeared, sometimes combined with limited adipose tissue hyperplasia, hypertrophy.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.