Differential Diagnosis

The patient's symptoms of low side of normal WBC and neutrophils, bloating, constipation, heavy periods, and night sweats can be approached by considering the following categories:

• Single Most Likely Diagnosis

  • Hypothyroidism: This condition can cause a decrease in WBC and neutrophils, as well as symptoms like bloating, constipation, heavy periods, and night sweats due to the metabolic slowdown associated with thyroid hormone deficiency.

• Other Likely Diagnoses

  • Anemia: Heavy periods can lead to iron deficiency anemia, which might cause a slight decrease in WBC and neutrophils, along with symptoms like bloating and constipation due to decreased intestinal motility and night sweats due to anemia-related hypoxia.
  • Polycystic Ovary Syndrome (PCOS): Although PCOS primarily presents with irregular periods, some patients may experience heavy periods. It can also cause bloating, constipation, and night sweats due to hormonal imbalances and insulin resistance.
  • Adrenal Insufficiency: This condition can lead to a decrease in WBC and neutrophils and cause symptoms like bloating, constipation, and night sweats due to the lack of cortisol and aldosterone.

• Do Not Miss Diagnoses

  • Hemochromatosis: Although rare, this genetic disorder can cause anemia, bloating, constipation, and night sweats due to iron overload. It's crucial to diagnose early to prevent organ damage.
  • Lymphoma or Leukemia: These conditions can cause a decrease in WBC and neutrophils, as well as night sweats. Although less likely, they are critical to rule out due to their severity.
  • Pernicious Anemia: An autoimmune condition causing vitamin B12 deficiency, which can lead to a decrease in WBC and neutrophils, along with gastrointestinal symptoms like bloating and constipation.

• Rare Diagnoses

  • Wilson's Disease: A genetic disorder causing copper accumulation, which can lead to anemia, bloating, constipation, and night sweats.
  • Celiac Disease: An autoimmune reaction to gluten, causing malabsorption, which might lead to a decrease in WBC and neutrophils, along with gastrointestinal symptoms.
  • Autoimmune Disorders (e.g., Lupus, Rheumatoid Arthritis): These conditions can cause a decrease in WBC and neutrophils, as well as a wide range of systemic symptoms, including bloating, constipation, and night sweats.