Differential Diagnosis for Macrocytic Hematoria and Stomach Pain
- Single Most Likely Diagnosis
- Pernicious anemia: This condition is characterized by a deficiency in vitamin B12, which is essential for the production of red blood cells. The lack of intrinsic factor in the stomach, necessary for vitamin B12 absorption, leads to macrocytic anemia and can cause stomach pain due to atrophic gastritis.
- Other Likely Diagnoses
- Vitamin B12 deficiency: Similar to pernicious anemia, a deficiency in vitamin B12 can cause macrocytic anemia, and stomach pain may be present due to various underlying causes such as celiac disease or Crohn's disease.
- Folate deficiency: Folate is another crucial nutrient for red blood cell production, and its deficiency can lead to macrocytic anemia. Stomach pain may be associated with conditions like celiac disease or inflammatory bowel disease that can cause folate malabsorption.
- Alcohol-related macrocytosis: Chronic alcohol consumption can lead to macrocytic anemia and stomach pain due to gastritis or other alcohol-related gastrointestinal issues.
- Do Not Miss Diagnoses
- Gastric cancer: Although less common, gastric cancer can cause stomach pain and macrocytic anemia due to chronic blood loss or malabsorption of essential nutrients.
- Celiac disease: This autoimmune disorder can lead to malabsorption of vitamin B12 and folate, resulting in macrocytic anemia, and stomach pain is a common symptom.
- Rare Diagnoses
- Congenital disorders of folate metabolism: These are rare genetic conditions that affect the body's ability to metabolize folate, leading to macrocytic anemia.
- Medication-induced macrocytosis: Certain medications, such as methotrexate or phenytoin, can cause macrocytic anemia as a side effect, and stomach pain may be present due to other medication-related gastrointestinal issues.