Differential Diagnosis for Male Anemia in a Five Year-Old Kid

Single Most Likely Diagnosis

• Picky eater-related nutritional deficiency: Given the child's history of being a picky eater and having autism disorder, it's likely that their diet lacks essential nutrients, leading to anemia. Although iron studies are on the lower side of normal, other nutritional deficiencies such as vitamin B12 or folate deficiency could be contributing to the anemia.

Other Likely Diagnoses

• Celiac disease: This condition is more common in children with autism and can lead to malabsorption of essential nutrients, including iron, folate, and vitamin B12, causing anemia.
• Gastrointestinal blood loss: Although iron studies are normal, gastrointestinal blood loss from conditions like Meckel's diverticulum or inflammatory bowel disease could be causing anemia.
• Chronic disease: Autism disorder can be associated with chronic inflammation, which may contribute to anemia of chronic disease.

Do Not Miss Diagnoses

• Lead poisoning: This condition can cause anemia and is more common in children with pica or those who ingest non-food items, which may be more prevalent in children with autism.
• Inherited disorders of hemoglobin synthesis: Although less likely, conditions like beta-thalassemia trait or other hemoglobinopathies can cause anemia and may not be immediately apparent on initial iron studies.

Rare Diagnoses

• Intrinsic factor deficiency: A rare condition that can lead to vitamin B12 deficiency and anemia.
• Gaucher's disease: A rare genetic disorder that can cause anemia due to bone marrow infiltration.
• Other rare genetic disorders: Such as Pearson syndrome or congenital disorders of glycosylation, which can cause anemia and other systemic symptoms.