Differential Diagnosis for Abnormal Laboratory Study Results
The patient presents with fatigue, low hematocrit, and low platelet count, which suggests an underlying condition affecting the blood cells. The differential diagnosis can be categorized as follows:
- Single Most Likely Diagnosis
- D. iron deficiency anemia: The patient's low hematocrit (29%) and low ferritin level (25 ng/mL) are indicative of iron deficiency anemia. The mean corpuscular volume (MCV) is within the normal range, but the low ferritin level suggests depleted iron stores. Iron deficiency anemia is a common cause of fatigue, especially in older adults.
- Other Likely Diagnoses
- A. anemia of chronic disease: Although the patient's past medical history is unremarkable, anemia of chronic disease is a possibility, especially if there is an underlying condition that has not been diagnosed. However, the low ferritin level and normal MCV make iron deficiency anemia more likely.
- C. folic acid deficiency: Folic acid deficiency can cause anemia, but it is less likely in this case, as the MCV is within the normal range. Folic acid deficiency typically causes macrocytic anemia (high MCV).
- Do Not Miss Diagnoses
- E. myelodysplastic syndrome: Although rare, myelodysplastic syndrome (MDS) is a potentially life-threatening condition that can cause anemia, thrombocytopenia, and leukopenia. The patient's age and abnormal laboratory results make it essential to consider MDS, even if it is less likely.
- Rare Diagnoses
- B. beta-thalassemia: Beta-thalassemia is a genetic disorder that can cause anemia, but it is rare in adults, especially those without a known family history. The patient's normal MCV and lack of other symptoms make beta-thalassemia less likely.
In conclusion, iron deficiency anemia is the most likely cause of the patient's abnormal laboratory study results, but it is essential to consider other possibilities, including anemia of chronic disease, folic acid deficiency, and myelodysplastic syndrome, to ensure a comprehensive diagnosis and treatment plan.