Differential Diagnosis
The patient's laboratory results show elevated glucose, alkaline phosphatase, and anion gap, with a low albumin-to-globulin (A/G) ratio. Based on these findings, the following differential diagnoses are considered:
- Single most likely diagnosis
- Diabetes Mellitus: Elevated glucose level (111) suggests diabetes mellitus, which is a common condition in the elderly population. The patient's age (79) and glucose level support this diagnosis.
- Other Likely diagnoses
- Chronic Liver Disease: Elevated alkaline phosphatase (184) and low A/G ratio (1.00) may indicate chronic liver disease, such as cirrhosis or liver fibrosis.
- Dehydration: Elevated BUN (16) and creatinine (0.96) may suggest dehydration, which is common in elderly patients.
- Primary Biliary Cholangitis: Elevated alkaline phosphatase (184) may also indicate primary biliary cholangitis, an autoimmune liver disease.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Lactic Acidosis: Elevated anion gap (13) may indicate lactic acidosis, a life-threatening condition that requires prompt treatment.
- Sepsis: Elevated glucose (111) and anion gap (13) may also suggest sepsis, a potentially fatal condition that requires immediate attention.
- Adrenal Insufficiency: Low A/G ratio (1.00) and elevated glucose (111) may indicate adrenal insufficiency, a rare but potentially life-threatening condition.
- Rare diagnoses
- Wilson's Disease: Elevated alkaline phosphatase (184) and low A/G ratio (1.00) may suggest Wilson's disease, a rare genetic disorder that affects copper metabolism.
- Hemochromatosis: Elevated alkaline phosphatase (184) may also indicate hemochromatosis, a rare genetic disorder that affects iron metabolism.
- Alpha-1 Antitrypsin Deficiency: Elevated alkaline phosphatase (184) may suggest alpha-1 antitrypsin deficiency, a rare genetic disorder that affects the lungs and liver.