Differential Diagnosis for a 30-year-old Lady with Abnormal Iron Studies and Blood Count
Single Most Likely Diagnosis
- Iron Deficiency Anemia: This is the most likely diagnosis given the low serum iron (9 umol/L), low transferrin saturation (0.11), and low ferritin (39 ug/L) levels. The patient's haemoglobin and hematocrit are within the normal range, but the MCV (79 fL) and MCH (26 pg) are slightly below the normal range, indicating microcytic anemia. The elevated platelet count (443 x 10e9/L) is also consistent with iron deficiency anemia.
Other Likely Diagnoses
- Chronic Disease: The patient's low ferritin and low transferrin saturation could also be indicative of an underlying chronic disease, such as chronic inflammation or infection, which can lead to anemia of chronic disease.
- Thalassemia Trait: The patient's microcytic anemia (low MCV) and normal hemoglobin level could also suggest a thalassemia trait, although the ferritin level is low, which is not typical for thalassemia.
Do Not Miss Diagnoses
- Celiac Disease: This condition can cause iron deficiency anemia due to malabsorption of iron. It is essential to consider this diagnosis, as it can have significant implications for the patient's health and management.
- Gastrointestinal Bleeding: Although the patient's hemoglobin and hematocrit are within the normal range, it is crucial to rule out gastrointestinal bleeding as a cause of iron deficiency anemia, as it can be a sign of a more serious underlying condition.
Rare Diagnoses
- Pregnancy-Related Anemia: Although the patient is 30 years old, it is essential to consider pregnancy as a potential cause of iron deficiency anemia, especially if the patient is not using contraception or has not had a recent pregnancy test.
- Hemoglobinopathy: Other hemoglobinopathies, such as sickle cell trait or hemoglobin C disease, can also cause microcytic anemia, although they are less common than iron deficiency anemia or thalassemia trait.