Differential Diagnosis for Headache in Children with Low Ferritin

• Single most likely diagnosis
  • Iron deficiency anemia: This condition is a common cause of headache in children, and low ferritin levels are a hallmark of iron deficiency. Iron deficiency can lead to decreased oxygen delivery to tissues, including the brain, potentially causing headaches.
• Other Likely diagnoses
  • Migraine: Although not directly related to low ferritin, migraines are a common cause of headaches in children and can be exacerbated by various factors, including nutritional deficiencies.
  • Tension headache: Similar to migraines, tension headaches are common in children and may not have a direct link to low ferritin but could be influenced by overall health and nutritional status.
  • Anemia of chronic disease: Conditions like chronic infections, inflammatory diseases, or malignancies can lead to anemia and low ferritin levels, potentially causing headaches due to decreased oxygen delivery.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Subarachnoid hemorrhage or other intracranial hemorrhages: Although rare, these conditions can present with sudden, severe headache and may be associated with anemia due to blood loss. Missing these diagnoses could be fatal.
  • Brain tumors: Some brain tumors can cause anemia or affect iron metabolism, leading to low ferritin levels. Headache is a common presenting symptom, especially if the tumor increases intracranial pressure.
  • Leukemia: Certain types of leukemia can cause anemia and low ferritin levels. Headache could be a symptom due to increased intracranial pressure from leukemic infiltration.
• Rare diagnoses
  • Porphyrias: A group of rare genetic disorders that can affect heme synthesis, leading to neurological symptoms including headaches. Some forms may be associated with anemia or abnormal iron metabolism.
  • Wilson's disease: A rare genetic disorder affecting copper metabolism, which can lead to neurological symptoms, including headaches, and potentially affect iron levels or metabolism indirectly.