Unintentional weight loss is often defined as weight loss of at least 5% of the patient's usual body weight that occurs within the preceding 6 to 12 months, and that is not the expected consequence of treatment of a known illness.[1] Unintentional weight loss is a diagnostic challenge because, while an underlying illness may be found after a thorough history and physical exam, the etiology may remain elusive and only be discovered through additional testing, the passage of time, or not at all. The most pressing concern is the assessment for the presence of cancer or other conditions for which early diagnosis may lead to better outcomes. There is a broad range of causes of unintentional weight loss including medical diseases, psychiatric illnesses, and social factors. These conditions may occur in isolation or in combination.
Summary
Classification
There is no formal consensus definition of unintentional weight loss; however, the weight loss must be considered unintentional by the patient and treating practitioner. The degree of unintentional weight loss has been defined in case series as being between 5% and 10% weight loss compared with usual body weight.[2] [3] [4] [5] [6] [7] [8] [9] Similarly, there is no strict definition of the time period in which the unintentional weight loss should occur; however, most case series used the criteria of weight loss developing within the preceding 3 to 12 months.
Related syndromes include cachexia and sarcopenia. Cachexia is a syndrome of weight loss characterized by decreased muscle mass in the presence of the metabolic effects of an underlying illness such as some types of cancer or advanced heart failure.[10] [11] [12] While all patients with cachexia have unintentional weight loss, not all patients with unintentional weight loss have cachexia. Sarcopenia is a geriatric syndrome of diminished muscle mass and function, which may or may not be accompanied by unintentional weight loss.[13]
A consensus definition of malnutrition includes unintentional weight loss (>5% in 3 months, or >10% of indefinite time) as a component of one set of diagnostic criteria.[14]
In the US, the Centers for Medicare and Medicaid Services require that long-term care facilities conduct an assessment when a resident has an unplanned weight loss problem (5% change in 30 days or 10% change in 180 days), together with another area of decline.[15]
Epidemiology
In population-based cohort studies, the prevalence of unintentional weight loss varies between 7% and 13%, with differences attributable to both demographics and duration of follow-up.[16] [17] [18] The prevalence in older adults (those ages >65 years) is reportedly 15% to 20%; however, clinical and epidemiologic studies have reported even higher prevalence in certain populations, with as many as 27% of community-dwelling elderly people and 50% to 60% of nursing home residents being affected.[19] [20] For patients with the most clinically applicable presentation (i.e., weight loss occurring within the preceding 6 months), the prevalence is approximately 7%.[18]
A significant association between mortality and unintentional weight loss in older people, and in overweight and obese subjects, has been demonstrated in subgroup analysis of one systematic review and meta-analysis.[21] In an earlier observational study, patients with recent unintentional weight loss (i.e., within 6 months), a weight loss of ≥5% was associated with an increase in subsequent mortality.[18]
Unintentional weight loss has been associated with increased perioperative complications in patients undergoing gynecologic surgery, colorectal surgery, and surgery for disseminated cancer.[22] [23] [24] Unintentional weight loss has been associated with high rates of hospital admission in an outpatient cohort and in patients with dementia in care home settings.[25] [26]
Unintentional weight loss represents a striking contrast to the epidemics of obesity in many countries and the commonplace experience of unsuccessful attempts at intentional weight reduction. Furthermore, unintentional weight loss may be under-recognized in the primary care setting.[27]
Pathophysiology
The pathophysiology varies depending on the etiology. Weight homeostasis is a complex process that includes the availability of food, physical activity, possible environmental exposures, and hormonal control with peptides such as leptin, cholecystokinin, and ghrelin.[28]
Unintentional weight loss owing to cachexia is associated with cytokines (e.g., tumor necrosis factor-alpha) that suppress appetite, promote muscle and fat breakdown, and increase energy expenditure.[29] [30] Normal homeostasis signaling is disrupted in cachexia syndromes, while these mechanisms are preserved in the setting of weight loss due purely to inadequate caloric intake.
Differential diagnosis
The differential diagnosis is extremely broad. In case series, the most common etiologies are:[31]
- Malignancy
- Gastrointestinal conditions
- Psychiatric causes
Other etiologies that should be considered include:
- Cachexia syndromes associated with organ failure (e.g., heart failure, chronic obstructive pulmonary disease, stage 5 chronic kidney disease)
- Endocrinopathies (e.g., hyperthyroidism, diabetes mellitus, adrenal insufficiency)
- Serious infections (e.g., tuberculosis, HIV)
- Medication adverse effects
- Substance misuse
- Social factors that prevent adequate access to food
Library
Citations
Wong CJ. Involuntary weight loss. Med Clin North Am. 2014;98:625-43.[Abstract]
McMinn J, Steel C, Bowman A. Investigation and management of unintentional weight loss in older adults. BMJ. 2011 Mar 29;342:d1732.[Abstract]
National Institute for Health and Care Excellence. Suspected cancer: recognition and referral. Jan 2026 [internet publication].[Full Text]
1. Wong CJ. Involuntary weight loss. Med Clin North Am. 2014;98:625-43.[Abstract]
2. Marton KI, Sox HC, Krupp JR. Involuntary weight loss: diagnostic and prognostic significance. Ann Intern Med. 1981;95:568-74.[Abstract]
3. Rabinovitz M, Pitlik SD, Leifer M, et al. Unintentional weight loss: a retrospective analysis of 154 cases. Arch Intern Med. 1986;146:186-7.[Abstract]
4. Thompson MP, Morris LK. Unexplained weight loss in the ambulatory elderly. J Am Geriatr Soc. 1991;39:497-500.[Abstract]
5. Wallace JI, Schwartz RS, LaCroix AZ, et al. Involuntary weight loss in older outpatients: incidence and clinical significance. J Am Geriatr Soc. 1995;43:329-37.[Abstract]
6. Bilbao-Garay J, Barba R, Losa-Garcia JE, et al. Assessing clinical probability of organic disease in patients with involuntary weight loss: a simple score. Eur J Intern Med. 2002;13:240-5.[Abstract]
7. Chen SP, Peng LN, Lin MH, et al. Evaluating probability of cancer among older people with unexplained, unintentional weight loss. Arch Gerontol Geriatr. 2010;50(suppl 1):S27-9.[Abstract]
8. Wu JM, Lin MH, Peng LN, et al. Evaluating diagnostic strategy of older patients with unexplained unintentional body weight loss: a hospital-based study. Arch Gerontol Geriatr. 2011;53:51-4.[Abstract]
9. Bosch X, Monclús E, Escoda O, et al. Unintentional weight loss: Clinical characteristics and outcomes in a prospective cohort of 2677 patients. PLoS One. 2017 Apr 7;12(4):e0175125. [Abstract][Full Text]
10. Evans WJ, Morley JE, Argiles J, et al. Cachexia: a new definition. Clin Nutr. 2008;27:793-9.[Abstract]
11. Arends J, Strasser F, Gonella S, et al. Cancer cachexia in adult patients: ESMO clinical practice guidelines(☆). ESMO Open. 2021 Jun;6(3):100092.[Abstract][Full Text]
12. Vest AR, Chan M, Deswal A, et al. Nutrition, obesity, and cachexia in patients with heart failure: a consensus statement from the Heart Failure Society of America Scientific Statements Committee. J Card Fail. 2019 May;25(5):380-400.[Abstract]
13. Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019 Jan 1;48(1):16-31.[Abstract][Full Text]
14. Cederholm T, Bosaeus I, Barazzoni R, et al. Diagnostic criteria for malnutrition: an ESPEN consensus statement. Clin Nutr. 2015;34:335-40.[Abstract][Full Text]
15. Centers for Medicare and Medicaid Services. State operations manual, appendix PP - guidance to surveyors for long term care facilities. Feb 2023 [internet publication].[Full Text]
16. Gregg EW, Gerzoff RB, Thompson TJ, et al. Intentional weight loss and death in overweight and obese U.S. adults 35 years of age and older. Ann Intern Med. 2003;138:383-9.[Abstract][Full Text]
17. Wannamethee SG, Shaper AG, Lennon L. Reasons for intentional weight loss, unintentional weight loss, and mortality in older men. Arch Intern Med. 2005;165:1035-40.[Abstract][Full Text]
18. Sahyoun NR, Serdula MK, Galuska DA. The epidemiology of recent involuntary weight loss in the United States population. J Nutr Health Aging. 2004;8:510-7.[Abstract]
19. Alibhai SM, Greenwood C, Payette H. An approach to the management of unintentional weight loss in elderly people. CMAJ. 2005 Mar 15;172(6):773-80.[Abstract][Full Text]
20. Bouras EP, Lange SM, Scolapio JS. Rational approach to patients with unintentional weight loss. Mayo Clin Proc. 2001 Sep;76(9):923-9.[Abstract][Full Text]
21. De Stefani FDC, Pietraroia PS, Fernandes-Silva MM, et al. Observational evidence for unintentional weight loss in all-cause mortality and major cardiovascular events: a systematic review and meta-analysis. Sci Rep. 2018 Oct 18;8(1):15447.[Abstract][Full Text]
22. Pache B, Grass F, Hübner M, et al. Prevalence and consequences of preoperative weight loss in gynecologic surgery. Nutrients. 2019 May 17;11(5):1094.[Abstract][Full Text]
23. Moghadamyeghaneh Z, Hanna MH1, Hwang G, et al. Outcome of preoperative weight loss in colorectal surgery. Am J Surg. 2015;210:291-7.[Abstract]
24. Thirunavukarasu P, Sanghera S, Singla S, et al. Pre-operative unintentional weight loss as a risk factor for surgical outcomes after elective surgery in patients with disseminated cancer. Int J Surg. 2015;18:7-13.[Abstract]
25. Duan R, Zhang Q, Zhu J, et al. The association between GLIM criteria-defined malnutrition and 2-year unplanned hospital admission in outpatients with unintentional weight loss: a retrospective cohort study. JPEN J Parenter Enteral Nutr. 2023 Jul;47(5):624-34.[Abstract]
26. Afonso-Argilés FJ, Meyer G, Stephan A, et al. Emergency department and hospital admissions among people with dementia living at home or in nursing homes: results of the European RightTimePlaceCare project on their frequency, associated factors and costs. BMC Geriatr. 2020 Nov 5;20(1):453.[Abstract][Full Text]
27. El-Kareh R, Pazo V, Wright A, et al. Losing weights: failure to recognize and act on weight loss documented in an electronic health record. J Innov Health Inform. 2015;22:316-22.[Abstract][Full Text]
28. Guyenet SJ, Schwartz MW. Regulation of food intake, energy balance, and body fat mass: implications for the pathogenesis and treatment of obesity. J Clin Endocrinol Metab. 2012;97:745-55.[Abstract][Full Text]
29. Fearon KC, Glass DJ, Guttridge DC. Cancer cachexia: mediators, signaling, and metabolic pathways. Cell Metabolism. 2012;16:153-66.[Abstract]
30. Argiles JM, Busquets S, Felipe A, et al. Molecular mechanisms involved in muscle wasting in cancer and ageing: cachexia versus sarcopenia. Int J Biochem Cell Biol. 2005;37:1084-104.[Abstract]
31. McMinn J, Steel C, Bowman A. Investigation and management of unintentional weight loss in older adults. BMJ. 2011 Mar 29;342:d1732.[Abstract]
32. Vierboom YC, Preston SH, Stokes A. Patterns of weight change associated with disease diagnosis in a national sample. PLoS One. 2018;13(11):e0207795.[Abstract][Full Text]
33. Nicholson BD, Virdee P, Aveyard P, et al. Prioritising primary care patients with unexpected weight loss for cancer investigation: diagnostic accuracy study (update). BMJ. 2024 Oct 16;387:e080199.[Abstract][Full Text]
34. Nicholson BD, Aveyard P, Hamilton W, et al. When should unexpected weight loss warrant further investigation to exclude cancer? BMJ. 2019 Sep 23;366:l5271.[Abstract][Full Text]
35. Nicholson BD, Hamilton W, O'Sullivan J, et al. Weight loss as a predictor of cancer in primary care: a systematic review and meta-analysis. Br J Gen Pract. 2018 May;68(670):e311-22.[Abstract][Full Text]
36. Tan BH, Fearon KC. Cachexia: prevalence and impact in medicine. Curr Opin Clin Nutr Metab Care. 2008;11:400-7.[Abstract]
37. O'Donoghue N, Shrotriya S, Aktas A, et al. Clinical significance of weight changes at diagnosis in solid tumours. Support Care Cancer. 2019 Jul;27(7):2725-33.[Abstract]
38. National Cancer Institute Surveillance, Epidemiology, and End Results Program. Cancer stat facts: myeloma. 2023 [internet publication].[Full Text]
39. Koo MM, Swann R, McPhail S, et al. Presenting symptoms of cancer and stage at diagnosis: evidence from a cross-sectional, population-based study. Lancet Oncol. 2020 Jan;21(1):73-9.[Abstract][Full Text]
40. Zhang X, Ma L, Bao H, et al. Clinical, pathological and prognostic characteristics of gastroenteropancreatic neuroendocrine neoplasms in China: a retrospective study. BMC Endocr Disord. 2014;14:54.[Abstract][Full Text]
41. O'Connor JM, Marmissolle F, Bestani C, et al. Observational study of patients with gastroenteropancreatic and bronchial neuroendocrine tumors in Argentina: results from the large database of a multidisciplinary group clinical multicenter study. Mol Clin Oncol. 2014;2:672-84.[Abstract][Full Text]
42. Gibril F, Schumann M, Pace A, et al. Multiple endocrine neoplasia type 1 and Zollinger-Ellison syndrome: a prospective study of 107 cases and comparison with 1009 cases from the literature. Medicine (Baltimore). 2004;83:43-83.[Abstract]
43. Clifton WL, Kneitz A, Cohn WE, et al. Weight loss caused by visceral artery disease. Tex Heart Inst J. 2013;40:320-2.[Abstract][Full Text]
44. Hansen KJ, Wilson DB, Craven TE, et al. Mesenteric artery disease in the elderly. J Vasc Surg. 2004;40:45-52.[Abstract][Full Text]
45. Goodall R, Langridge B, Onida S, et al. Median arcuate ligament syndrome. J Vasc Surg. 2020 Jun;71(6):2170-6.[Abstract][Full Text]
46. American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed., text revision (DSM-5-TR). Washington, DC: American Psychiatric Publishing; 2022.
47. World Health Organization. International classification of diseases, 11th revision (ICD-11). Chapter 6. Mental, behavioural and neurodevelopmental disorders. 2022. [Full Text]
48. Ziegelstein RC. Depression in patients recovering from a myocardial infarction. JAMA. 2001;286:1621-7.[Abstract]
49. Allida S, Cox KL, Hsieh CF, et al. Pharmacological, psychological, and non-invasive brain stimulation interventions for treating depression after stroke. Cochrane Database Syst Rev. 2020 Jan 28;1:CD003437.[Abstract][Full Text]
50. Mitchell AJ, Chan M, Bhatti H, et al. Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: a meta-analysis of 94 interview-based studies. Lancet Oncol. 2011;12:160-74.[Abstract]
51. Sripongpunkul C, Petchlorlian A, Chattaris T, et al. Factors associated with unintentional weight loss among older adults in a geriatric outpatient clinic of university hospital. PLoS One. 2021 Nov 18;16(11):e0260233.[Abstract][Full Text]
52. Anker SD, Ponikowski P, Varney S, et al. Wasting as independent risk factor for mortality in chronic heart failure. Lancet. 1997;349:1050-53.[Abstract]
53. Rossignol P, Masson S, Barlera S, et al. Loss in body weight is an independent prognostic factor for mortality in chronic heart failure: insights from the GISSI-HF and Val-HeFT trials. Eur J Heart Fail. 2015;17:424-33.[Abstract][Full Text]
54. Robinson RG. Poststroke depression: prevalence, diagnosis, treatment, and disease progression. Biol Psychiatry. 2003;54:376-87.[Abstract]
55. Wagner PD. Possible mechanisms underlying the development of cachexia in COPD. Eur Respir J. 2008;31:492-501.[Abstract][Full Text]
56. Pencharz PB, Durie PR. Pathogenesis of malnutrition in cystic fibrosis, and its treatment. Clin Nutr. 2000;19:387-94.[Abstract]
57. Milla CE. Nutrition and lung disease in cystic fibrosis. Clin Chest Med. 2007;28:319-30.[Abstract]
58. Mak RH, Cheung W. Cachexia in chronic kidney disease: role of inflammation and neuropeptide signaling. Curr Opin Nephrol Hypertens. 2007;16:27-31.[Abstract]
59. Wiersinga WM, Poppe KG, Effraimidis G. Hyperthyroidism: aetiology, pathogenesis, diagnosis, management, complications, and prognosis. Lancet Diabetes Endocrinol. 2023 Apr;11(4):282-98.[Abstract]
60. Boelaert K, Torlinska B, Holder RL, et al. Older subjects with hyperthyroidism present with a paucity of symptoms and signs: a large cross-sectional study. J Clin Endocrinol Metab. 2010;95:2715-26.[Abstract]
61. Ross IL, Levitt NS. Addison's disease symptoms - a cross sectional study in urban South Africa. PLoS One. 2013;8:e53526.[Abstract][Full Text]
62. Iannuzzi MC, Rybicki BA, Teirstein AS. Sarcoidosis. N Engl J Med. 2007;357:2153-65.[Abstract][Full Text]
63. Fauci AS, Wolff SM. Wegener's granulomatosis: studies in eighteen patients and a review of the literature. Medicine (Baltimore). 1973;52:535-61.[Abstract]
64. Hira SK, Dupont HL, Lanjewar DN, et al. Severe weight loss: the predominant clinical presentation of tuberculosis in patients with HIV infection in India. Natl Med J India. 1998;11:256-8.[Abstract]
65. Gonzalez Saldana N, Macias Parra M, Hernandez Porras M, et al. Pulmonary tuberculous: symptoms, diagnosis and treatment. 19-year experience in a third level pediatric hospital. BMC Infect Dis. 2014;14:401.[Abstract][Full Text]
66. Miller LG, Asch SM, Yu El, et al. A population-based survey of tuberculosis symptoms: how atypical are atypical presentations? Clin Infect Dis. 2000;30:293-9.[Abstract][Full Text]
67. Ayoade F, Cotelingam J, Joel Chandranesan AS. Disseminated Mycobacterium avium-intracellulare complex infection presenting with disseminated intravascular coagulation in an AIDS patient. J Investig Med High Impact Case Rep. 2017 Oct-Dec;5(4):2324709617740904.[Abstract][Full Text]
68. Petri WA. Recent advances in amebiasis. Crit Rev Clin Lab Sci. 1996;33:1-37.[Abstract]
69. Tobón AM, Agudelo CA, Rosero DS, et al. Disseminated histoplasmosis: a comparative study between patients with acquired immunodeficiency syndrome and non-human immunodeficiency virus-infected individuals. Am J Trop Med Hyg. 2005;73:576-82.[Abstract]
70. Couppié P, Herceg K, Bourne-Watrin M, et al. The broad clinical spectrum of disseminated histoplasmosis in HIV-infected patients: a 30 years' experience in French Guiana. J Fungi (Basel). 2019 Dec 13;5(4):115.[Abstract][Full Text]
71. Di Filippo L, De Lorenzo R, D'Amico M, et al. COVID-19 is associated with clinically significant weight loss and risk of malnutrition, independent of hospitalisation: a post-hoc analysis of a prospective cohort study. Clin Nutr. 2021 Apr;40(4):2420-6.[Abstract][Full Text]
72. Di Filippo L, De Lorenzo R, Cinel E, et al. Weight trajectories and abdominal adiposity in COVID-19 survivors with overweight/obesity. Int J Obes (Lond). 2021 Sep;45(9):1986-94.[Abstract][Full Text]
73. Lim J, Ko YH, Joe SH. Zonisamide produces weight loss in psychotropic drug-treated psychiatric outpatients. Prog Neuropsychopharmacol Biol Psychiatry. 2011;35:1918-21.[Abstract]
74. Li Z, Maglione M, Tu W, et al. Meta-analysis: pharmacologic treatment of obesity. Ann Intern Med. 2005;142:532-46.[Abstract]
75. Pérez-Hernández O, González-Pérez JM, Martínez-Riera A, et al. Involuntary weight loss secondary to metformin use in elderly adults. J Am Geriatr Soc. 2016;64:899-900.[Abstract][Full Text]
76. Solymár M, Ivic I, Pótó L, et al. Metformin induces significant reduction of body weight, total cholesterol and LDL levels in the elderly - A meta-analysis. PLoS One. 2018 Nov 26;13(11):e0207947.[Abstract][Full Text]
77. Soysal P, Isik AT, Stubbs B, et al. Acetylcholinesterase inhibitors are associated with weight loss in older people with dementia: a systematic review and meta-analysis. J Neurol Neurosurg Psychiatry. 2016 Dec;87(12):1368-74.[Abstract]
78. Ghusn W, De la Rosa A, Sacoto D, et al. Weight loss outcomes associated with semaglutide treatment for patients with overweight or obesity. JAMA Netw Open. 2022 Sep 1;5(9):e2231982.[Abstract][Full Text]
79. Hilas O, Avena-Woods C. Potential role of mirtazapine in underweight older adults. Consult Pharm. 2014 Feb;29(2):124-30.[Abstract]
80. Garcia L, Qi L, Rasor M, et al. The relationship of violence and traumatic stress to changes in weight and waist circumference: longitudinal analyses from the study of women's health across the nation. J Interpers Violence. 2014;29:1459-76.[Abstract]
81. Diabetes UK. The management of diabetic ketoacidosis in adults*. Mar 2023 [internet publication].[Full Text]
82. Almario CV, Chey WD, Iriana S, et al. Computer versus physician identification of gastrointestinal alarm features. Int J Med Inform. 2015;84:1111-7.[Abstract]
83. Nicholson BD, Thompson MJ, Hobbs FDR, et al. Measured weight loss as a precursor to cancer diagnosis: retrospective cohort analysis of 43 302 primary care patients. J Cachexia Sarcopenia Muscle. 2022 Oct;13(5):2492-503.[Abstract][Full Text]
84. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16:606-13.[Abstract][Full Text]
85. Kroenke K, Spitzer RL, Williams JB, et al. Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. Ann Intern Med. 2007;146:317-25.[Abstract]
86. Sun S, Schiller JH, Gazdar AF. Lung cancer in never smokers - a different disease. Nat Rev Cancer. 2007;7:778-90.[Abstract]
87. Subramanian J, Govindan R. Lung cancer in never smokers: a review. Clin Oncol. 2007;25:561-70.[Abstract]
88. Maki N, Nakatani E, Ojima T, et al. The cause of anorexia and proportion of its recovery in older adults without underlying disease: Results of a retrospective study. PLoS One. 2019;14(10):e0224354.[Abstract][Full Text]
89. Wilson DB, Mostafavi K, Craven TE, et al. Clinical course of mesenteric artery stenosis in elderly Americans. Arch Intern Med. 2006;166:2095-100.[Abstract][Full Text]
90. Ashton JJ, Smith R, Smith T, et al. Investigating coeliac disease in adults. BMJ. 2020 Jun 17;369:m2176.[Abstract]
91. Assi HA, Khoury KE, Dbouk H, et al. Epidemiology and prognosis of breast cancer in young women. J Thorac Dis. 2013;5(suppl 1):S2-8.[Abstract][Full Text]
92. Lockhart PB, Brennan MT, Thornhill M, et al. Poor oral hygiene as a risk factor for infective endocarditis-related bacteremia. J Am Dent Assoc. 2009 Oct;140(10):1238-44.[Abstract][Full Text]
93. National Institute for Health and Care Excellence. Suspected cancer: recognition and referral. Jan 2026 [internet publication].[Full Text]
94. National Institute for Health and Care Excellence. Quantitative faecal immunochemical testing to guide colorectal cancer pathway referral in primary care. Aug 2023 [internet publication].[Full Text]
95. Rex DK, Boland CR, Dominitz JA, et al. Colorectal cancer screening: recommendations for physicians and patients from the U.S. Multi-Society Task Force on colorectal cancer. Am J Gastroenterol. 2017 Jul;112(7):1016-30.[Abstract][Full Text]
96. Patel SG, May FP, Anderson JC, et al. Updates on age to start and stop colorectal cancer screening: recommendations from the U.S. Multi-Society Task Force on Colorectal Cancer. Gastroenterology. 2022 Jan;162(1):285-99.[Abstract][Full Text]
97. Rao S, Kikano EG, Smith DA, et al. Unintentional weight loss: what radiologists need to know and what clinicians want to know. Abdom Radiol (NY). 2021 May;46(5):2236-50.[Abstract]
98. Lordick F, Carneiro F, Cascinu S, et al. Gastric cancer: ESMO clinical practice guideline for diagnosis, treatment and follow-up. Ann Oncol. 2022 Oct;33(10):1005-20.[Abstract][Full Text]
99. Obermannová R, Alsina M, Cervantes A, et al. Oesophageal cancer: ESMO clinical practice guideline for diagnosis, treatment and follow-up. Ann Oncol. 2022 Oct;33(10):992-1004.[Abstract][Full Text]
100. Abu-Freha N, Lior Y, Shoher S, et al. The yield of endoscopic investigation for unintentional weight loss. Eur J Gastroenterol Hepatol. 2017 May;29(5):602-7.[Abstract]
101. Goh Y, Dan YY, Chua W, et al. Diagnostic utility of whole body CT scanning in patients with unexplained weight loss. PLoS One. 2018 Jul 27;13(7):e0200686.[Abstract][Full Text]
102. O'Cearbhaill RM, Leonard C, O'Neill D, et al. Is CT thorax, abdomen and pelvis a useful test in patients with weight loss? J Med Imaging Radiat Oncol. 2022 Apr;66(3):345-50.[Abstract]
103. Noblett D, Kwong A, Corwin MT, et al. Prevalence of malignancy on contrast-enhanced computed tomography of the abdomen and pelvis in patients with unexplained, unintentional weight loss. J Comput Assist Tomogr. 2021 Sep-Oct 01;45(5):663-8.[Abstract]
104. Hernandez JL, Riancho JA, Matorras P, et al. Clinical evaluation for cancer in patients with involuntary weight loss without specific symptoms. Am J Med. 2003;114:631-7.[Abstract]
105. Hernandez JL, Matorras P, Riancho JA, et al. Involuntary weight loss without specific symptoms: a clinical prediction score for malignant neoplasm. Q J Med. 2003;96:649-55.[Abstract][Full Text]
106. Baicus C, Rimbas M, Baicus A, et al. Cancer and involuntary weight loss: failure to validate a prediction score. PLoS One. 2014 Apr 24;9(4):e95286.[Abstract][Full Text]
107. Baicus C, Ionescu R, Tanasescu C. Does this patient have cancer? The assessment of age, anemia, and erythrocyte sedimentation rate in cancer as a cause of weight loss. A retrospective study based on a secondary care university hospital in Romania. Eur J Intern Med. 2006;17:28-31.[Abstract]
108. Grobbee EJ, Wisse PHA, Schreuders EH, et al. Guaiac-based faecal occult blood tests versus faecal immunochemical tests for colorectal cancer screening in average-risk individuals. Cochrane Database Syst Rev. 2022 Jun 6;6(6):CD009276.[Abstract][Full Text]
109. Provenzale D, Ness RM, Llor X, et al. NCCN guidelines insights: colorectal cancer screening, version 2.2020. J Natl Compr Canc Netw. 2020 Oct 1;18(10):1312-20.[Abstract][Full Text]
110. Hill ID, Dirks MH, Liptak GS, et al. Guideline for the diagnosis and treatment of celiac disease in children: recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr. 2005 Jan;40(1):1-19.[Abstract][Full Text]
111. Kumar V, Jarzabek-Chorzelska M, Sulej J, et al. Celiac disease and immunoglobulin a deficiency: how effective are the serological methods of diagnosis? Clin Diagn Lab Immunol. 2002 Nov;9(6):1295-300.[Abstract][Full Text]
112. Chaudrey KH. ACG guideline: diagnosis and management of celiac disease. Am J Gastroenterol. 2023 Jan 1;118(1):23.[Abstract][Full Text]
113. Sheppard AL, Elwenspoek MMC, Scott LJ, et al. Systematic review with meta-analysis: the accuracy of serological tests to support the diagnosis of coeliac disease. Aliment Pharmacol Ther. 2022 Mar;55(5):514-27.[Abstract][Full Text]
114. Sciurti M, Fornaroli F, Gaiani F, et al. Genetic susceptibility and celiac disease: what role do HLA haplotypes play? Acta Biomed. 2018 Dec 17;89(9-s):17-21.[Abstract][Full Text]
115. National Institute for Health and Care Excellence. Eating disorders: recognition and treatment. Dec 2020 [internet publication].[Full Text]
116. Lewinsohn DM, Leonard MK, LoBue PA, et al. Official American Thoracic Society/Infectious Diseases Society of America/Centers for Disease Control and Prevention clinical practice guidelines: diagnosis of tuberculosis in adults and children. Clin Infect Dis. 2017 Jan 15;64(2):111-5.[Abstract][Full Text]
117. Geldmacher H, Taube C, Kroeger C, et al. Assessment of lymph node tuberculosis in Northern Germany: a clinical review. Chest. 2002 Apr;121(4):1177-82.[Abstract]
118. Weir MR, Thornton GF. Extrapulmonary tuberculosis. Experience of a community hospital and review of the literature. Am J Med. 1985 Oct;79(4):467-78.[Abstract]
119. Baydur A. The spectrum of extrapulmonary tuberculosis. West J Med. 1977 Apr;126(4):253-62.[Abstract][Full Text]
120. Nataraj G, Kurup S, Pandit A, et al. Correlation of fine needle aspiration cytology, smear and culture in tuberculous lymphadenitis: a prospective study. J Postgrad Med. 2002 Apr-Jun;48(2):113-6.[Abstract][Full Text]
121. Muneer A, Macrae B, Krishnamoorthy S, et al. Urogenital tuberculosis - epidemiology, pathogenesis and clinical features. Nat Rev Urol. 2019 Oct;16(10):573-98.[Abstract]
122. World Health Organization. WHO consolidated guidelines on tuberculosis: module 3: diagnosis. Apr 2025 [internet publication].[Full Text]
123. Centers for Disease Control and Prevention (CDC). Updated guidelines for the use of nucleic acid amplification tests in the diagnosis of tuberculosis. MMWR Morb Mortal Wkly Rep. 2009 Jan 16;58(1):7-10.[Abstract][Full Text]
124. Bjerrum S, Schiller I, Dendukuri N, et al. Lateral flow urine lipoarabinomannan assay for detecting active tuberculosis in people living with HIV. Cochrane Database Syst Rev. 2019 Oct 21;10(10):CD011420.[Abstract][Full Text]
125. Chen LK, Woo J, Assantachai P, et al. Asian Working Group for Sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment. J Am Med Dir Assoc. 2020 Mar;21(3):300-7.e2.[Abstract]
126. Dent E, Morley JE, Cruz-Jentoft AJ, et al. International clinical practice guidelines for sarcopenia (ICFSR): screening, diagnosis and management. J Nutr Health Aging. 2018;22(10):1148-61.[Abstract][Full Text]
127. Vogel A, Bridgewater J, Edeline J, et al. Biliary tract cancer: ESMO clinical practice guideline for diagnosis, treatment and follow-up. Ann Oncol. 2023 Feb;34(2):127-40.[Abstract][Full Text]
128. Nishimura K, Sugiyama D, Kogata Y, et al. Meta-analysis: diagnostic accuracy of anti-cyclic citrullinated peptide antibody and rheumatoid factor for rheumatoid arthritis. Ann Intern Med. 2007 Jun 5;146(11):797-808.[Abstract]
129. Taylor P, Gartemann J, Hsieh J, et al. A systematic review of serum biomarkers anti-cyclic citrullinated peptide and rheumatoid factor as tests for rheumatoid arthritis. Autoimmune Dis. 2011;2011:815038.[Abstract][Full Text]
130. Robson JC, Grayson PC, Ponte C, et al. 2022 American College of Rheumatology/European Alliance of Associations for Rheumatology classification criteria for granulomatosis with polyangiitis. Ann Rheum Dis. 2022 Mar;81(3):315-20.[Abstract][Full Text]
131. Talha KM, DeSimone DC, Sohail MR, et al. Pathogen influence on epidemiology, diagnostic evaluation and management of infective endocarditis. Heart. 2020 Dec;106(24):1878-82.[Abstract]
