Infantile rickets is rare, but osteomalacia may occur in severe adult celiac disease. Protein malabsorption may lead to hypoproteinemic edema, usually of the lower limbs. Dehydration, K loss, and muscle weakness can follow profuse diarrhea. Diagnosis Symptoms and signs lead to the diagnostic impression of malabsorption. Any combination of weight loss, diarrhea, and anemia should raise the suspicion of malabsorption.
Laboratory studies confirm the diagnosis.
Direct measurement of fecal fat is the most reliable test for establishing malabsorption. Steatorrhea is absolute evidence of malabsorption but is not always present. Accuracy of stool collections is important. Stool inspection and microscopic examination are valuable. The typical stool appearances described above are unmistakable.