Differential Diagnosis for a 75 YOF with Multiple Falls, Severe Weakness, Anorexia, and a WBC of 1.1
- Single Most Likely Diagnosis
- Vitamin B12 Deficiency: This condition can lead to severe weakness, anorexia, and a low white blood cell count (leukopenia) due to its crucial role in DNA synthesis and maintenance of the nervous system. The patient's age and symptoms align with a potential deficiency, possibly due to malabsorption or dietary lack.
- Other Likely Diagnoses
- Chronic Infections (e.g., Tuberculosis, Endocarditis): Chronic infections can cause prolonged fever, weight loss, anorexia, and weakness. A low WBC count could be indicative of bone marrow suppression or severe infection.
- Malignancy (e.g., Leukemia, Lymphoma): Certain cancers can lead to weakness, anorexia, and a decreased WBC count due to bone marrow infiltration or suppression.
- Hypothyroidism: Severe hypothyroidism can cause weakness, anorexia, and potentially affect the immune system, though a direct link to a significantly low WBC count is less common.
- Do Not Miss Diagnoses
- Sepsis: Although the WBC count is low, sepsis can present with an initial leukopenia, especially in elderly or immunocompromised patients. The severe weakness and anorexia could be indicative of a systemic infection.
- Aplastic Anemia: A condition where the bone marrow fails to produce blood cells, leading to severe weakness, anorexia, and a critically low WBC count, making the patient highly susceptible to infections.
- Drug-Induced Agranulocytosis: Certain medications can cause a drastic reduction in WBCs, leading to severe infections. Given the patient's age, polypharmacy could be a contributing factor.
- Rare Diagnoses
- Myelodysplastic Syndromes (MDS): A group of disorders caused by poorly formed or dysfunctional blood cells, which could explain the low WBC count and other symptoms.
- Pernicious Anemia: An autoimmune condition leading to vitamin B12 deficiency, which could be considered if other causes of B12 deficiency are ruled out.
- Congenital or Acquired Immune Deficiencies: Though less likely in a 75-year-old presenting for the first time, certain immune deficiencies could lead to recurrent infections and the described symptoms.