Differential Diagnosis for 74 y.o. male with thrombocytopenia, peripheral neuropathy, cryoglobulinemia after febrile illness
- Single most likely diagnosis
- Hepatitis C infection: This is a common cause of cryoglobulinemia, and the patient's symptoms of thrombocytopenia and peripheral neuropathy are consistent with this diagnosis. Hepatitis C is known to cause extrahepatic manifestations, including cryoglobulinemic vasculitis, which can lead to these symptoms.
- Other Likely diagnoses
- Mixed cryoglobulinemia: This condition is characterized by the presence of cryoglobulins in the blood, which can cause vasculitis, thrombocytopenia, and peripheral neuropathy. It can be associated with various underlying conditions, including infections, autoimmune disorders, and malignancies.
- Monoclonal gammopathy of undetermined significance (MGUS): This condition is characterized by the presence of a monoclonal protein in the blood, which can cause thrombocytopenia and peripheral neuropathy. While MGUS is often asymptomatic, it can be associated with various systemic symptoms, including those seen in this patient.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Multiple myeloma: This malignancy can cause thrombocytopenia, peripheral neuropathy, and cryoglobulinemia, and is often associated with a poor prognosis if left untreated. Although it may not be the most likely diagnosis, it is essential to consider and rule out multiple myeloma due to its potential severity.
- Systemic lupus erythematosus (SLE): This autoimmune disorder can cause a wide range of systemic symptoms, including thrombocytopenia, peripheral neuropathy, and cryoglobulinemia. While SLE may not be the most likely diagnosis, it is crucial to consider and rule out due to its potential severity and the need for prompt treatment.
- Rare diagnoses
- Waldenström's macroglobulinemia: This rare lymphoproliferative disorder is characterized by the presence of a monoclonal protein in the blood, which can cause thrombocytopenia, peripheral neuropathy, and cryoglobulinemia.
- POEMS syndrome: This rare paraneoplastic syndrome is characterized by polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes, and can cause thrombocytopenia and cryoglobulinemia.