Differential Diagnosis for Leukocytosis and GI Bleed
Single Most Likely Diagnosis
- Upper GI bleed due to peptic ulcer disease: This is a common cause of GI bleeding and can lead to leukocytosis due to stress response, possible infection, or inflammation.
Other Likely Diagnoses
- Inflammatory bowel disease (IBD): Conditions like Crohn's disease and ulcerative colitis can cause both GI bleeding and leukocytosis due to chronic inflammation and possible infection.
- Diverticulitis: Inflammation of a diverticulum can lead to bleeding and an elevated white blood cell count.
- Gastroenteritis: Severe infections of the GI tract can cause both symptoms, especially if there's an invasive bacterial infection.
Do Not Miss Diagnoses
- Mesenteric ischemia: Although less common, this condition can lead to both GI bleeding and leukocytosis. It's critical to diagnose promptly as it can be life-threatening.
- Sepsis from a GI source: Any infection that leads to sepsis can cause leukocytosis, and if the source is GI (like a perforated viscus), it could also cause GI bleeding.
- Neutropenic colitis (typhlitis): Especially in immunocompromised patients, this condition can present with GI bleeding and may initially have leukocytosis before progressing to neutropenia.
Rare Diagnoses
- Hemolytic uremic syndrome (HUS): Although more commonly associated with renal failure and microangiopathic hemolytic anemia, some cases can present with GI symptoms and bleeding.
- Vasculitis (e.g., Henoch-Schönlein purpura): Systemic vasculitis can affect the GI tract, leading to bleeding and may also cause leukocytosis due to inflammation.
- GI lymphoma or other malignancies: These can cause both GI bleeding and systemic symptoms like leukocytosis, especially if there's associated infection or inflammation.