Differential Diagnosis of Blood Levels of Neutrophils Extracellular Traps (NETs)
Single Most Likely Diagnosis
- Sepsis: Elevated levels of NETs are often associated with sepsis, a life-threatening condition that arises when the body's response to infection causes injury to its own tissues and organs. NETs are formed as part of the innate immune response to trap and kill pathogens, and their levels can increase significantly in septic patients.
Other Likely Diagnoses
- Infectious Diseases: Various infections, including bacterial, viral, and fungal infections, can lead to increased NET formation as the body attempts to combat the invading pathogens.
- Autoimmune Disorders: Conditions such as rheumatoid arthritis, lupus, and vasculitis can also result in elevated NET levels due to the chronic inflammatory state and immune system dysregulation.
- Malignancies: Certain types of cancer, including leukemia and lymphoma, may lead to increased NET formation, potentially as a result of the tumor cells interacting with the immune system.
Do Not Miss Diagnoses
- Disseminated Intravascular Coagulation (DIC): Although not the most common condition associated with elevated NETs, DIC is a critical diagnosis to consider due to its high mortality rate. NETs can contribute to the coagulation abnormalities seen in DIC.
- Thrombotic Microangiopathies: Conditions like thrombotic thrombocytopenic purpura (TTP) and hemolytic uremic syndrome (HUS) involve microvascular thrombosis and can be associated with elevated NET levels, making them important not to miss due to their severity and the need for specific treatments.
Rare Diagnoses
- Autoinflammatory Disorders: Rare conditions such as familial Mediterranean fever or periodic fever syndromes can lead to elevated NET levels due to their underlying inflammatory pathophysiology.
- Primary Immunodeficiencies: Certain immunodeficiencies may result in abnormal NET formation or function, leading to recurrent infections or other complications.
- Small Vessel Vasculitis: Conditions like granulomatosis with polyangiitis (formerly known as Wegener's granulomatosis) can be associated with NETs, although they are less common than other vasculitides.