Differential Diagnosis for Anemia of Unknown Cause
Single Most Likely Diagnosis
- Iron Deficiency Anemia: This is often the most common cause of anemia, especially in women due to menstrual blood loss, and in individuals with gastrointestinal bleeding or poor dietary intake. It's a straightforward diagnosis to consider first due to its prevalence.
Other Likely Diagnoses
- Vitamin B12 Deficiency: This can lead to megaloblastic anemia and is common in individuals with dietary deficiencies (e.g., vegans), malabsorption syndromes, or pernicious anemia.
- Folate Deficiency: Similar to B12 deficiency, folate deficiency can cause megaloblastic anemia and is often seen in pregnant women, individuals with poor diets, or those with malabsorption issues.
- Chronic Disease Anemia: Conditions like chronic kidney disease, rheumatoid arthritis, and chronic infections can lead to anemia of chronic disease, which is characterized by a lack of iron utilization despite adequate iron stores.
Do Not Miss Diagnoses
- Leukemia or Lymphoma: Although less common, these malignancies can present with anemia as an initial symptom. Missing these diagnoses could be fatal, making them critical to rule out.
- Myelodysplastic Syndromes (MDS): These are a group of disorders caused by poorly formed or dysfunctional blood cells, often presenting with anemia and potentially progressing to acute leukemia if not addressed.
- HIV/AIDS: Infection with HIV can lead to various forms of anemia, including anemia of chronic disease, and is crucial to diagnose due to its significant impact on patient management and prognosis.
Rare Diagnoses
- Paroxysmal Nocturnal Hemoglobinuria (PNH): A rare, acquired, life-threatening disease of the blood characterized by the destruction of red blood cells, bone marrow failure, and the potential for thrombotic events.
- Sickle Cell Disease or Other Hemoglobinopathies: While more common in certain populations, these genetic disorders can cause anemia due to abnormal hemoglobin production and are important to consider in the appropriate clinical context.
- Gaucher's Disease: A genetic disorder that can lead to anemia due to spleen enlargement and subsequent sequestration of red blood cells, among other systemic effects.