Differential Diagnosis
The patient's laboratory results show low iron levels (7.4), low unsaturated iron-binding capacity (UIBC) (37.7), slightly elevated total iron-binding capacity (TIBC) (45.1), low hemoglobin (HGB) (11.2), normal mean corpuscular volume (MCV) (81), and normal mean corpuscular hemoglobin (MCH) (25). Based on these results, the differential diagnosis can be categorized as follows:
- Single most likely diagnosis
- Iron deficiency anemia: The patient's low iron level and elevated TIBC are indicative of iron deficiency anemia. The low hemoglobin level and normal MCV and MCH also support this diagnosis.
- Other Likely diagnoses
- Anemia of chronic disease: The patient's low iron level and low UIBC could also be seen in anemia of chronic disease. However, the TIBC is typically low or normal in this condition, making iron deficiency anemia more likely.
- Mixed iron deficiency and anemia of chronic disease: It is possible that the patient has a combination of iron deficiency and anemia of chronic disease, which could explain the low iron level and elevated TIBC.
- Do Not Miss
- Thalassemia: Although the patient's MCV and MCH are normal, thalassemia minor can sometimes present with normal or slightly elevated MCV and MCH. It is essential to consider this diagnosis to avoid missing a genetic disorder.
- Hemoglobinopathy: Other hemoglobinopathies, such as sickle cell disease or hemoglobin C disease, can also present with anemia and normal MCV and MCH. Although less likely, these conditions should not be missed due to their significant clinical implications.
- Rare diagnoses
- Sideroblastic anemia: This rare condition is characterized by abnormal iron metabolism and can present with anemia, low iron level, and elevated TIBC. However, it is typically associated with other clinical features, such as ringed sideroblasts on bone marrow biopsy.
- Atransferrinemia: This rare genetic disorder is characterized by a lack of transferrin, leading to low iron level and elevated TIBC. However, it is extremely rare and typically presents with more severe clinical features.