Complete investigations with sweat test, ESR, CRP

You discuss the results with Davina’s parents. You explain that the antibody tests show that she has antibody’s against gluten, which is a protein found in wheat, so is present in bread, pasta, biscuit. This finding, combined with her poor weight gain, is suggestive of coeliac disease, which is an allergic condition of the small intestine. In this condition, the lining of the intestine becomes inflamed because of the gluten in the diet. The consequence of this is that the intestine does not absorb nutrients properly.

The parents are not sure about this information.

However, there are some outstanding results and it would also be prudent to exclude other causes, such as cystic fibrosis. For this, she will need further tests to be done.

Davina’s parents tell you that they cannot make a decision immediately and need some time to think.

You book them into the clinic in one week’s time.