Differential Diagnosis for Heavy Menstrual Cycle and Low Hemoglobin
Single Most Likely Diagnosis
- Iron Deficiency Anemia: This is the most likely diagnosis given the patient's heavy menstrual cycle and low hemoglobin level (6.6 g/dL). Heavy menstrual bleeding is a common cause of iron deficiency anemia in adolescent females.
Other Likely Diagnoses
- Dysfunctional Uterine Bleeding: This condition is characterized by abnormal uterine bleeding that is not associated with any underlying medical condition. It is a common cause of heavy menstrual bleeding in adolescents.
- Thyroid Disorders: Both hypothyroidism and hyperthyroidism can cause heavy menstrual bleeding. Thyroid function tests should be performed to rule out these conditions.
- Von Willebrand Disease: This is a bleeding disorder that can cause heavy menstrual bleeding. It is more common in females and can be diagnosed with laboratory tests.
Do Not Miss Diagnoses
- Bleeding Disorders (e.g., Hemophilia, Factor XI Deficiency): Although less common, these conditions can cause severe bleeding and should not be missed.
- Uterine Anomalies or Tumors: Conditions such as uterine fibroids or anomalies can cause heavy menstrual bleeding and should be ruled out with imaging studies.
- Coagulopathy (e.g., Disseminated Intravascular Coagulation, Thrombocytopenia): These conditions can cause severe bleeding and should be considered in the differential diagnosis.
Rare Diagnoses
- Hereditary Hemorrhagic Telangiectasia: This is a rare genetic disorder that can cause bleeding from multiple sites, including the uterus.
- Systemic Lupus Erythematosus: This autoimmune disorder can cause a variety of symptoms, including heavy menstrual bleeding.
- Leiomyosarcoma: This is a rare type of uterine cancer that can cause heavy menstrual bleeding.