Differential Diagnosis for a 13-year-old with Haemoglobin 8.3, Low Ferritin, and IGE Levels > 6000
- Single Most Likely Diagnosis
- Allergic disorders with iron deficiency anemia: The high IGE levels suggest an allergic condition, and the low ferritin indicates iron deficiency anemia. Conditions like atopic dermatitis, asthma, or allergic rhinitis could be contributing to both the elevated IGE and iron deficiency due to chronic inflammation or poor dietary intake.
- Other Likely Diagnoses
- Parasitic infections (e.g., hookworm): These can cause iron deficiency anemia due to chronic blood loss and may also elevate IGE levels as part of the body's immune response to the parasite.
- Inflammatory bowel disease (IBD): Conditions like Crohn's disease or ulcerative colitis can lead to iron deficiency anemia due to malabsorption and chronic inflammation. Elevated IGE levels might be seen in some cases, especially if there's an allergic component to the disease.
- Do Not Miss Diagnoses
- Celiac disease: Although it might not directly cause high IGE levels, celiac disease can lead to iron deficiency anemia due to malabsorption. It's crucial to consider because it's a condition that significantly impacts quality of life and requires a specific dietary intervention.
- Lymphoma: Certain types of lymphoma can cause elevated IGE levels and iron deficiency anemia. Although less common, missing a diagnosis of lymphoma could have severe consequences.
- Rare Diagnoses
- Hyper-IgE syndrome (Job syndrome): A rare condition characterized by recurrent cutaneous and pulmonary infections, and elevated IGE levels. It could potentially lead to iron deficiency anemia due to chronic disease.
- Gastrointestinal bleeding from a rare source (e.g., Meckel's diverticulum): This could cause iron deficiency anemia, and if there's an associated allergic or parasitic condition, it might also explain the high IGE levels.