Differential Diagnosis for a 65-year-old Female with ESR 100, High CRP, and Mesenteric Lymphadenitis
- Single Most Likely Diagnosis
- Crohn's Disease: This condition is a type of inflammatory bowel disease (IBD) that can cause mesenteric lymphadenitis, elevated ESR, and high CRP due to chronic inflammation. The age of the patient and the combination of symptoms make it a strong candidate.
- Other Likely Diagnoses
- Diverticulitis: Inflammation of the diverticula in the digestive tract can lead to mesenteric lymphadenitis and elevated inflammatory markers. The patient's age increases the likelihood of diverticulitis.
- Lymphoma: Both Hodgkin's and non-Hodgkin's lymphoma can present with lymphadenitis, including mesenteric lymph nodes, and systemic inflammation indicated by high ESR and CRP.
- Tuberculosis: Although less common in some regions, TB can cause mesenteric lymphadenitis and significant elevation in inflammatory markers. The diagnosis should be considered, especially if the patient has risk factors for TB exposure.
- Do Not Miss Diagnoses
- Abdominal Lymphoma: Given the potential for lymphoma to present with nonspecific symptoms and the critical importance of early diagnosis, it's essential not to miss this diagnosis.
- Intra-abdominal Infection or Abscess: Conditions such as an abscess or severe infection within the abdomen can cause significant elevation in inflammatory markers and must be promptly identified and treated to prevent severe outcomes.
- Sarcoidosis: Although less common, sarcoidosis can cause lymphadenitis and elevated inflammatory markers. Missing this diagnosis could lead to delayed treatment and potential complications.
- Rare Diagnoses
- Whipple's Disease: A rare, systemic bacterial infection that can cause malabsorption, lymphadenopathy, and elevated inflammatory markers. It's crucial to consider in cases where common diagnoses are ruled out.
- Castleman Disease: A rare disorder that involves an overgrowth of cells in the body's lymph nodes, which can cause lymphadenitis and systemic inflammation.
- Kikuchi-Fujimoto Disease: A rare condition that affects the lymph nodes, causing lymphadenitis, and can present with systemic inflammation. It's more common in younger females but should be considered in the differential diagnosis of lymphadenitis.