Differential Diagnosis
- Single most likely diagnosis
- Acute Myeloid Leukemia (AML): The presence of significant immature myeloid cells on the peripheral blood smear, along with anemia (low hemoglobin), thrombocytopenia (low platelets), and leukocytosis (high leukocytes) are highly suggestive of AML. The elevated lactate dehydrogenase (LDH) and uric acid levels also support this diagnosis, as they are commonly elevated in leukemia due to cell turnover and breakdown.
- Other Likely diagnoses
- Acute Lymphoblastic Leukemia (ALL): Although the presence of immature myeloid cells suggests AML, ALL is also a possibility, especially in a pediatric patient. The symptoms of fatigue, nausea, and bruising could be seen in ALL as well.
- Severe Aplastic Anemia: This condition, characterized by bone marrow failure, could explain the patient's anemia, thrombocytopenia, and fatigue. However, the presence of immature myeloid cells and elevated LDH and uric acid make this diagnosis less likely.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
- Sepsis: The patient's elevated leukocyte count and symptoms of fatigue and nausea could be indicative of sepsis, a life-threatening condition that requires immediate attention.
- Disseminated Intravascular Coagulation (DIC): The patient's thrombocytopenia and ecchymoses could be signs of DIC, a condition that can be fatal if not promptly treated.
- Rare diagnoses
- Myelodysplastic Syndrome (MDS): This group of disorders is characterized by bone marrow dysfunction and could explain the patient's anemia and thrombocytopenia. However, MDS is rare in pediatric patients, making it a less likely diagnosis.
- Lymphoma: Although lymphoma can present with similar symptoms, the presence of immature myeloid cells on the peripheral blood smear makes this diagnosis less likely.