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Symptoms and Signs - ​Differential Diagnosis of Appetite Loss in Infants and Children
• Rheumatoid arthritis (RA)
• Rheumatic fever
• Nutritional: marasmus, iron deficiency, zinc deficiency
• Neurologic: congenital degenerative disease
• Miscellaneous: prolonged restriction of oral feedings, beginning in the neonatal period; systemic lupus erythematosus (SLE); tumor
• Metabolic: renal failure or renal tubular acidosis, liver failure, congenital metabolic disease, lead poisoning
• Infectious (acute or chronic)
• Hypothalamic lesion: increased intracranial pressure (including a brain tumor), swallowing disorders (neuromuscular)
• Gastrointestinal: oral lesions (e.g., thrush or herpes simplex), gastroesophageal reflux, obstruction (especially with gastric or intestinal distention), inflammatory bowel disease (IBD), celiac disease, constipation
• Fever
• Excessive weight loss and food aversion in athletes, simulating anorexia nervosa
• Drugs: morphine, digitalis, antimetabolites, methylphenidate, amphetamines
• Cardiac: congestive heart failure (CHF) (especially associated with cyanotic lesions)
• Avoidance of symptoms associated with meals (abdominal pain, diarrhea, bloating, urgency, dumping syndrome)
• Anxiety, fear, depression, mania (limbic influence on the hypothalamus)
• Anorexia nervosa
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