Differential Diagnosis for a 44-year-old Female with Fatigue
Single Most Likely Diagnosis
- Iron Deficiency Anemia: The patient's low ferritin level (11 ng/mL) is a strong indicator of iron deficiency, which is a common cause of fatigue. The normal hemoglobin and hematocrit levels are not provided, but the low ferritin level alone is sufficient to suggest iron deficiency anemia as the most likely diagnosis.
Other Likely Diagnoses
- Diabetes Mellitus: The patient's high glucose level (106 mg/dL) suggests impaired glucose regulation, which could be contributing to her fatigue.
- Hypothyroidism: Although not directly indicated by the lab results, hypothyroidism is a common cause of fatigue in women, and thyroid function tests (TSH, free T4) are not provided.
- Chronic Kidney Disease: The patient's eGFR is normal (101 mL/min/1.73m2), but the BUN and creatinine levels are slightly elevated, which could indicate early kidney disease.
Do Not Miss Diagnoses
- Adrenal Insufficiency: Although rare, adrenal insufficiency can cause fatigue, and the patient's low sodium level (139 mmol/L) and high potassium level (5.1 mmol/L) could be indicative of this condition.
- Pituitary or Hypothalamic Dysfunction: These conditions can cause fatigue, and the patient's low ferritin level could be related to hypothalamic-pituitary-adrenal axis dysfunction.
Rare Diagnoses
- Hemochromatosis: Although the patient's ferritin level is low, hemochromatosis can cause fatigue, and the patient's high glucose level could be related to pancreatic damage from iron overload.
- Wilson's Disease: This rare genetic disorder can cause fatigue, and the patient's low ferritin level could be related to copper overload.
- Mitochondrial Myopathies: These rare genetic disorders can cause fatigue, and the patient's high glucose level could be related to mitochondrial dysfunction.