Differential Diagnosis for a 12-year-old Boy with Mild Anemia, Repetitive Stress Injury, and Numbness

• Single most likely diagnosis:
  • Peripheral neuropathy due to repetitive stress injury: This is a plausible explanation for the numbness in the hands and feet, given the history of repetitive stress injury. The mild anemia could be a contributing factor to the neuropathy.
• Other Likely diagnoses:
  • Vitamin B12 deficiency: This can cause mild anemia and neuropathy, leading to numbness in the hands and feet.
  • Iron deficiency anemia: Similar to vitamin B12 deficiency, iron deficiency can cause anemia and neuropathy.
  • Diabetes mellitus: Although less common in children, diabetes can cause neuropathy and numbness in the hands and feet.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
  • Guillain-Barré syndrome: A rare autoimmune disorder that can cause rapid onset of numbness and weakness in the hands and feet.
  • Leukemia or lymphoma: Certain types of cancer can cause anemia and neuropathy, making it essential to rule out these conditions.
  • Sickle cell disease: A genetic disorder that can cause anemia and neuropathy, particularly in individuals of African or Mediterranean descent.
• Rare diagnoses:
  • Charcot-Marie-Tooth disease: A genetic disorder that affects the peripheral nerves, causing numbness and weakness in the hands and feet.
  • Friedreich's ataxia: A rare genetic disorder that can cause neuropathy, ataxia, and anemia.
  • Porphyria: A group of rare genetic disorders that can cause neuropathy, abdominal pain, and anemia.