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Diagnosis on a positive fashion of nonorganic failure to thrive

Fabio Panetta1, Domenico Magazzù, Concetta Sferlazzas

  • 1Cystic Fibrosis and Paediatric Gastroenterology Unit, University of Messina, Messina, Italy.

Acta Paediatrica (Oslo, Norway : 1992)
|July 12, 2008
PubMed

Insights

Identifying nonorganic symptoms in children with failure to thrive (FTT) can accurately predict nonorganic FTT. However, the absence of nonorganic symptoms does not rule out this diagnosis, necessitating further investigation.

Area of Science:

  • Pediatrics
  • Child Health
  • Clinical Diagnosis

Background:

  • Failure to thrive (FTT) is a complex condition requiring accurate diagnosis.
  • Differentiating between organic and nonorganic causes of FTT is crucial for appropriate management.

Purpose of the Study:

  • To evaluate the predictive accuracy of specific symptoms and signs in classifying children with FTT into organic or nonorganic groups.
  • To determine the utility of clinical presentation in diagnosing nonorganic failure to thrive (NOFTT).

Main Methods:

  • A cohort of 208 outpatients aged 6 months to 14 years with FTT was studied.
  • Predefined clinical features were assessed as predictors for organic/nonorganic FTT.
  • All participants underwent a comprehensive diagnostic workup to rule out organic etiologies.

Main Results:

  • A high positive predictive value (96%) was observed for nonorganic symptoms in diagnosing NOFTT.
  • The negative predictive value for NOFTT was 92% when no organic symptoms were present.
  • The absence of nonorganic symptoms did not exclude a NOFTT diagnosis (41% negative predictive value).

Conclusions:

  • The presence of nonorganic symptoms, coupled with the absence of organic symptoms, strongly supports a diagnosis of NOFTT.
  • Limited laboratory investigations may be sufficient when nonorganic symptoms are identified, aiding in efficient diagnosis.
Abstract

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