Differential Diagnosis for Anemia with Normal Ferritin and Iron Levels
Single Most Likely Diagnosis
- Anemia of Chronic Disease: This condition is characterized by a chronic inflammatory state, which can lead to anemia despite normal iron stores. The inflammation can impair the utilization of iron, leading to a functional iron deficiency. Conditions such as chronic infections, autoimmune diseases, or cancer can cause anemia of chronic disease.
Other Likely Diagnoses
- Vitamin Deficiency Anemia: Deficiencies in vitamins such as B12 or folate can cause anemia. These deficiencies can occur due to inadequate dietary intake, malabsorption, or increased demand.
- Hemolytic Anemia: This condition involves the premature destruction of red blood cells. It can be caused by autoimmune disorders, infections, or inherited conditions.
- Renal Failure: Chronic kidney disease can lead to anemia due to a decrease in erythropoietin production, which is essential for red blood cell production.
Do Not Miss Diagnoses
- Leukemia or Lymphoma: These cancers can cause anemia due to bone marrow infiltration or suppression. Early detection is crucial for effective treatment.
- Thyroid Disorders: Both hypothyroidism and hyperthyroidism can cause anemia. Thyroid hormones play a role in erythropoiesis, and their imbalance can lead to anemia.
- Chronic Liver Disease: Liver disease can cause anemia due to a decrease in the production of proteins necessary for red blood cell production or due to portal hypertension leading to splenic sequestration.
Rare Diagnoses
- Pernicious Anemia: This is a rare autoimmune disorder that causes a deficiency in intrinsic factor, leading to vitamin B12 deficiency and anemia.
- Sideroblastic Anemia: This is a rare group of disorders characterized by the accumulation of iron in the mitochondria of red blood cell precursors, leading to anemia.
- Paroxysmal Nocturnal Hemoglobinuria (PNH): This is a rare, acquired, life-threatening disease of the blood characterized by the destruction of red blood cells, bone marrow failure, and the potential for blood clot formation.