What is the significance of low Iron (Fe) levels at 37-145 micrograms per deciliter (mcg/dL), high Total Iron-Binding Capacity (TIBC) at 228-428 mcg/dL, and low Iron Saturation at 20-55 percent?

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Differential Diagnosis for Iron Studies

The patient's iron studies show low iron levels (37-145 mcg/dL), high total iron-binding capacity (TIBC) (228-428 mcg/dL), and low iron saturation (20-55%). Based on these results, the following differential diagnoses can be considered:

  • Single most likely diagnosis
    • Iron deficiency anemia: This is the most likely diagnosis given the low iron levels, high TIBC, and low iron saturation. The body's iron stores are depleted, leading to a decrease in iron available for erythropoiesis.
  • Other Likely diagnoses
    • Anemia of chronic disease: This condition can also present with low iron levels and high TIBC, although the iron saturation may be normal or elevated due to the body's inflammatory response.
    • Chronic blood loss: Ongoing blood loss can lead to iron deficiency anemia, especially if the loss is not adequately compensated by dietary iron intake.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Celiac disease: This autoimmune disorder can lead to malabsorption of iron and other essential nutrients, resulting in iron deficiency anemia.
    • Gastric cancer: Chronic blood loss from a gastric malignancy can cause iron deficiency anemia, and early detection is crucial for treatment.
  • Rare diagnoses
    • Atransferrinemia: A rare genetic disorder characterized by the absence of transferrin, leading to impaired iron transport and utilization.
    • Aceruloplasminemia: A rare genetic disorder affecting iron metabolism, resulting in iron accumulation in tissues and potentially leading to iron deficiency anemia.

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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