Differential Diagnosis of AIHA with Mediastinal and Hilar Lymphadenopathy
Single Most Likely Diagnosis
- Lymphoma (e.g., Non-Hodgkin Lymphoma): This is a common cause of both autoimmune hemolytic anemia (AIHA) and mediastinal/hilar lymphadenopathy due to the production of autoantibodies against red blood cells by the malignant lymphocytes.
Other Likely Diagnoses
- Chronic Lymphocytic Leukemia (CLL): CLL can cause AIHA through the production of autoantibodies and can also present with lymphadenopathy, including in the mediastinal and hilar regions.
- Systemic Lupus Erythematosus (SLE): SLE is a systemic autoimmune disease that can cause AIHA and lymphadenopathy, among other symptoms, due to its widespread autoimmune effects.
- Hodgkin Lymphoma: Although less common than non-Hodgkin lymphoma in causing AIHA, Hodgkin lymphoma can also present with lymphadenopathy and autoimmune phenomena.
Do Not Miss Diagnoses
- Lymphoma with Sjögren's Syndrome: While less common, Sjögren's syndrome can be associated with lymphoma and AIHA, and missing this diagnosis could lead to delayed treatment of an underlying malignancy.
- Castleman Disease: A rare disorder that can cause lymphadenopathy and autoimmune phenomena, including AIHA. It's crucial not to miss this diagnosis due to its potential for severe complications if left untreated.
Rare Diagnoses
- Angioimmunoblastic T-cell Lymphoma: A rare and aggressive form of lymphoma that can present with AIHA and lymphadenopathy, among other systemic symptoms.
- Multicentric Castleman Disease: A rare condition that can mimic lymphoma and cause AIHA, lymphadenopathy, and systemic symptoms, often associated with HIV infection or other immunodeficiencies.
- Rheumatoid Arthritis with Felty's Syndrome: Although rare, Felty's syndrome (a complication of long-standing rheumatoid arthritis) can cause AIHA and lymphadenopathy, making it a differential diagnosis in patients with a history of rheumatoid arthritis.