SOLVED1932

A mother brings her 8-month-old girl to your office with anorexia, abdominal distention, discomfort, weight loss, and intermittent emesis. The mother notes the symptoms began about a month prior as isolated diarrhea. The child has been in daycare since she was 6 weeks of age, but she has no known ill contacts there or at home. You note that the child’s growth has been poor since the 6-month visit. The mother reports exclusive use of commercially available cow’s milk-based formula for the first 6 months of life, adding cereal and other baby food in the previous month. Anti-tissue transglutaminase IgA antibodies are present. Of the following, which is considered the most appropriate next step? A Initiate a lactose-free diet B Initiate a gluten-free diet C Replace the formula with hydrolyzed protein formula D Perform a biopsy of the distal colon E Perform a biopsy of the distal duodenum
SCIENCE
HEALTH SCIENCE
NURSING

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