Differential Diagnosis for Elevated Ferritin, Normal Iron, Negative ANA, Negative ESR, Negative CRP, Polyarthralgia in a 51-Year-Old Female
- Single Most Likely Diagnosis
- Ferritin-only Hyperferritinemia: This condition is characterized by elevated ferritin levels without iron overload or other clear causes. It can be associated with various symptoms, including polyarthralgia. The absence of elevated iron, ANA, ESR, and CRP, along with the presence of polyarthralgia, makes this a plausible diagnosis.
- Other Likely Diagnoses
- Hypothyroidism: Although not directly linked to elevated ferritin, hypothyroidism can cause polyarthralgia and may have a complex interplay with ferritin levels. It's essential to consider and rule out hypothyroidism given the patient's symptoms.
- Fibromyalgia: This condition is characterized by widespread musculoskeletal pain, including polyarthralgia, and could be considered in the differential diagnosis, especially if other causes are ruled out.
- Hemochromatosis (early stages): Although iron levels are normal, early stages of hemochromatosis might present with elevated ferritin before significant iron accumulation occurs. Genetic testing might be warranted if other risk factors are present.
- Do Not Miss Diagnoses
- Lymphoma: Certain types of lymphoma can cause elevated ferritin levels. Although less likely, missing a diagnosis of lymphoma could have severe consequences, making it crucial to consider, especially if other symptoms or signs suggestive of lymphoma are present.
- Sarcoidosis: This condition can cause elevated ferritin and might present with polyarthralgia among other symptoms. It's essential to rule out sarcoidosis due to its potential for serious complications if left untreated.
- Rare Diagnoses
- Hyperferritinemia Cataract Syndrome: A rare genetic disorder characterized by elevated ferritin levels and early-onset cataracts. It's an unlikely cause but should be considered if familial patterns or cataracts are present.
- Gaucher's Disease: A rare genetic disorder that can cause elevated ferritin among other symptoms. Although unlikely, it's a consideration, especially if there's a family history or other suggestive symptoms.