Differential Diagnosis for High ESR, Normal CRP, and Ulcers in Ileum
Single Most Likely Diagnosis
- Crohn's Disease: This condition is a type of inflammatory bowel disease (IBD) that can cause ulcers in the ileum, among other symptoms. The high ESR (erythrocyte sedimentation rate) indicates inflammation, which is consistent with Crohn's. The normal CRP (C-reactive protein) does not rule out Crohn's, as CRP can be normal in some cases, especially if the disease is not in an active flare.
Other Likely Diagnoses
- Intestinal Tuberculosis: This condition can cause ulcers in the ileum and may present with a high ESR due to chronic inflammation. The normal CRP does not exclude this diagnosis, as CRP can be normal in chronic infections.
- Yersinia Enterocolitica Infection: This bacterial infection can cause ileitis (inflammation of the ileum) and may present with a high ESR. The normal CRP does not rule out this diagnosis, as CRP can be normal in some bacterial infections.
- NSAID-Induced Enteropathy: Long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) can cause ulcers in the ileum and may present with a high ESR due to chronic inflammation.
Do Not Miss Diagnoses
- Lymphoma: Although less likely, lymphoma can cause ulcers in the ileum and may present with a high ESR due to malignancy. Missing this diagnosis could be deadly, so it's essential to consider it in the differential.
- Intestinal Ischemia: This condition can cause ulcers in the ileum and may present with a high ESR due to tissue damage. Missing this diagnosis could lead to severe complications, including bowel infarction.
Rare Diagnoses
- Behçet's Disease: This rare condition can cause ulcers in the ileum and may present with a high ESR due to chronic inflammation.
- Eosinophilic Gastroenteritis: This rare condition can cause ulcers in the ileum and may present with a high ESR due to chronic inflammation.
- Intestinal Amyloidosis: This rare condition can cause ulcers in the ileum and may present with a high ESR due to chronic inflammation.