Differential Diagnosis
The patient's laboratory results and symptoms suggest a differential diagnosis that can be categorized as follows:
- Single most likely diagnosis
- Anemia of Chronic Disease (ACD): The patient's iron studies (low iron saturation, normal ferritin, and elevated TIBC) and mild anemia with a high RDW suggest ACD. The presence of night sweats, which can be a symptom of chronic inflammation or infection, further supports this diagnosis.
- Other Likely diagnoses
- Iron Deficiency Anemia (IDA): Although the patient's ferritin levels are within the normal range, the low iron saturation and elevated TIBC suggest possible IDA. However, the absence of a clear source of iron loss and the presence of inflammation make ACD more likely.
- Mixed Anemia: The patient's laboratory results show features of both ACD (low iron saturation, normal ferritin) and IDA (elevated TIBC, low iron). A mixed anemia, with both chronic disease and iron deficiency components, is possible.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Lymphoma: Night sweats are a classic symptom of lymphoma, and the patient's anemia and elevated RDW could be indicative of a hematologic malignancy. Although the likelihood is low, lymphoma must be considered and ruled out.
- Tuberculosis: Night sweats are also a common symptom of tuberculosis, and the patient's anemia and elevated RDW could be related to chronic infection. Although the likelihood is low, tuberculosis must be considered and ruled out.
- Rare diagnoses
- Myelodysplastic Syndrome (MDS): The patient's anemia, elevated RDW, and abnormal iron studies could be indicative of MDS, a rare group of disorders characterized by bone marrow failure.
- Sideroblastic Anemia: The patient's elevated RDW and abnormal iron studies could be suggestive of sideroblastic anemia, a rare group of disorders characterized by abnormal iron metabolism and erythropoiesis.