Differential Diagnosis for Chronic Diarrhea, Splenomegaly, Leukocytosis, and Weight Loss
Single Most Likely Diagnosis
- Lymphoma: This is a strong consideration due to the combination of chronic diarrhea, splenomegaly, and weight loss, which can be indicative of a malignancy affecting the gastrointestinal system and spleen. Leukocytosis can also occur in response to lymphoma.
Other Likely Diagnoses
- Chronic infections (e.g., tuberculosis, HIV): These can cause chronic diarrhea, weight loss, and splenomegaly. Leukocytosis may be seen in response to infection.
- Inflammatory bowel disease (IBD): Conditions like Crohn's disease can lead to chronic diarrhea, weight loss, and sometimes splenomegaly due to systemic inflammation. Leukocytosis is common in active IBD.
- Sarcoidosis: Although less common, sarcoidosis can cause gastrointestinal symptoms, splenomegaly, and weight loss, along with leukocytosis due to the inflammatory nature of the disease.
Do Not Miss Diagnoses
- Whipple's disease: A rare bacterial infection that can cause chronic diarrhea, weight loss, and splenomegaly. It's crucial to consider due to its treatable nature with antibiotics, despite being rare.
- Amyloidosis: This condition can lead to gastrointestinal symptoms, splenomegaly, and weight loss. It's essential not to miss because it has specific treatment options and can be fatal if left untreated.
- Lymphatic or gastrointestinal malignancies other than lymphoma: These could include metastatic cancer to the spleen or gastrointestinal tract, which would require prompt diagnosis and treatment.
Rare Diagnoses
- Mastocytosis: A condition characterized by the accumulation of mast cells in various tissues, which can lead to gastrointestinal symptoms, splenomegaly, and weight loss.
- Eosinophilic gastroenteritis: A rare condition involving eosinophilic infiltration of the gastrointestinal tract, which can cause chronic diarrhea, weight loss, and potentially splenomegaly if there's systemic involvement.
- Abetalipoproteinemia: A very rare genetic disorder affecting fat absorption, leading to chronic diarrhea and weight loss, but it's less likely to cause significant splenomegaly or leukocytosis.