Differential Diagnosis for 13-year-old Boy with Abdominal Pain, Diarrhea, and Elevated ALP
- Single Most Likely Diagnosis
- Inflammatory bowel disease (IBD): The combination of abdominal pain, diarrhea, and elevated alkaline phosphatase (ALP) in a 13-year-old boy could suggest IBD, such as Crohn's disease or ulcerative colitis. Elevated ALP can occur due to liver or bone involvement, which can be seen in IBD.
- Other Likely Diagnoses
- Viral gastroenteritis: Although ALP is elevated, viral gastroenteritis could still be a consideration, especially if the boy has been exposed to a viral illness. However, the elevated ALP might not be directly related to the gastroenteritis.
- Bacterial gastroenteritis: Similar to viral gastroenteritis, bacterial causes could be considered, especially if there's a history of food poisoning or travel. The elevated ALP could be incidental or related to a specific bacterial infection affecting the liver or bones.
- Hepatitis: Acute hepatitis can cause abdominal pain, diarrhea, and elevated liver enzymes, including ALP. However, other liver enzymes would typically be elevated as well.
- Do Not Miss Diagnoses
- Appendicitis: Although the primary symptoms are abdominal pain and diarrhea, appendicitis can sometimes present atypically, especially in children. The elevated ALP is not typical but could be seen in cases with liver or bone involvement.
- Intussusception: This condition involves the telescoping of one portion of the intestine into another and can cause abdominal pain and diarrhea. It's a surgical emergency and must be considered, even though the elevated ALP is not a typical finding.
- Pancreatitis: Acute pancreatitis can cause abdominal pain and elevated pancreatic enzymes. While ALP can be elevated, it's not the primary enzyme associated with pancreatitis.
- Rare Diagnoses
- Wilson's disease: A genetic disorder that leads to copper accumulation in the liver and other organs. It can cause abdominal pain, diarrhea, and elevated liver enzymes, including ALP.
- Primary sclerosing cholangitis: A rare disease that causes scarring and narrowing of the bile ducts, leading to elevated liver enzymes, including ALP. It's often associated with IBD.
- Bone disorders (e.g., osteomalacia, rickets): These conditions can cause elevated ALP due to bone involvement but would typically have other clinical findings and abnormalities in other blood tests.