What is the diagnosis for a 39-year-old female (YOF: years old female) presenting with measles, now experiencing bilateral flank pain, leukopenia (WBC: white blood cell count 1.9 x 10^9/L), thrombocytopenia (platelets 108 x 10^9/L), and elevated C-reactive protein (CRP 26.7 mg/L)?

Differential Diagnosis for 39 YOF with Measles and Bilateral Flank Pain

Single Most Likely Diagnosis

• Measles-associated complications (e.g., measles-induced thrombocytopenia, anemia, or hepatitis): The patient's recent measles infection, combined with laboratory findings such as low WBC, thrombocytopenia, and elevated liver enzymes, suggests that the current presentation could be a complication of the measles infection itself.

Other Likely Diagnoses

• Viral hepatitis (e.g., hepatitis A, B, or C): The elevated ALT and conjugated bilirubin levels could indicate a hepatitis infection, which might be related to or exacerbated by the measles infection.
• Bacterial sepsis or infection: The patient's fever, elevated CRP, and low WBC count could suggest a bacterial infection, potentially complicating the measles infection or an independent condition.
• Immune thrombocytopenic purpura (ITP): The low platelet count could be indicative of ITP, which might be triggered by the measles infection.

Do Not Miss Diagnoses

• Hemophagocytic lymphohistiocytosis (HLH): Although rare, HLH is a life-threatening condition that can be triggered by viral infections, including measles. The patient's low WBC, thrombocytopenia, and elevated liver enzymes make this a crucial diagnosis not to miss.
• Sepsis with disseminated intravascular coagulation (DIC): The combination of fever, low platelets, and elevated CRP could also suggest sepsis with DIC, a condition that requires immediate attention.
• Acute kidney injury (AKI): The bilateral flank pain could indicate AKI, which might be related to the measles infection, dehydration, or other causes.

Rare Diagnoses

• Thrombotic thrombocytopenic purpura (TTP): Although rare, TTP could explain the patient's thrombocytopenia, anemia, and renal symptoms.
• Hemolytic uremic syndrome (HUS): This condition, characterized by hemolytic anemia, acute kidney injury, and thrombocytopenia, is rare but could be considered in the differential diagnosis.
• Measles-induced encephalitis or other neurological complications: While the patient presents with flank pain, it's essential to consider neurological complications of measles, especially given the potential for central nervous system involvement.