Differential Diagnosis for High Blood Pressure and Low Hemoglobin
- Single most likely diagnosis
- Hypertension with chronic blood loss or anemia: This could be due to various reasons such as gastrointestinal bleeding, menstrual disorders, or chronic diseases like kidney disease, which can cause both high blood pressure and low hemoglobin levels.
- Other Likely diagnoses
- Chronic Kidney Disease (CKD): CKD can lead to hypertension due to fluid overload and renin-angiotensin-aldosterone system activation, and anemia due to decreased erythropoietin production.
- Pregnancy-induced hypertension with anemia: Pregnant women can develop hypertension and anemia due to increased blood volume, nutritional deficiencies, or placental abnormalities.
- Sickle Cell Disease: This genetic disorder can cause anemia, and patients are also at risk of developing hypertension due to renal damage and other complications.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Pheochromocytoma: A rare tumor of the adrenal gland that can cause episodic or sustained hypertension, and anemia due to various mechanisms, including blood loss or bone marrow suppression.
- Aortic Stenosis: Severe aortic stenosis can lead to hypertension and anemia due to decreased cardiac output, and if left untreated, can be fatal.
- Hemorrhagic shock: Severe blood loss can cause both hypotension and anemia, but in some cases, blood pressure may be maintained or even elevated due to compensatory mechanisms.
- Rare diagnoses
- Polycythemia vera with myeloproliferative neoplasm-related anemia: Although polycythemia vera typically presents with elevated hemoglobin, some patients may develop anemia due to iron deficiency or other mechanisms, and hypertension is a common finding.
- Erythrocytosis with secondary anemia: Certain conditions like erythrocytosis can lead to increased red blood cell mass, but if accompanied by anemia, it may indicate a complex underlying disorder.
- Renal artery stenosis: This condition can cause hypertension due to decreased renal perfusion, and anemia may occur due to chronic kidney disease or other associated conditions.