Differential Diagnoses for Nephritis and Autoimmune Hemolytic Anemia

Single Most Likely Diagnosis

• Systemic Lupus Erythematosus (SLE): This is a chronic autoimmune disease that can affect various parts of the body, including the kidneys and blood. It is known to cause nephritis and autoimmune hemolytic anemia, making it a prime suspect in patients presenting with these symptoms.

Other Likely Diagnoses

• Rheumatoid Arthritis (RA): Although less common than SLE, RA can also lead to secondary Sjögren's syndrome or drug-induced lupus, which might present with nephritis and autoimmune hemolytic anemia.
• Sjögren's Syndrome: This autoimmune disorder primarily affects the glands that produce tears and saliva but can also involve the kidneys and cause hemolytic anemia in some cases.
• Mixed Connective Tissue Disease (MCTD): MCTD combines features of lupus, scleroderma, and rheumatoid arthritis, and patients can exhibit a wide range of symptoms, including nephritis and autoimmune hemolytic anemia.

Do Not Miss Diagnoses

• Wegener's Granulomatosis (Granulomatosis with Polyangiitis, GPA): This is a rare autoimmune disorder that can cause kidney inflammation and damage, along with anemia. Missing this diagnosis could lead to severe complications, including kidney failure and respiratory issues.
• Microscopic Polyangiitis (MPA): Similar to GPA, MPA is a form of vasculitis that affects small blood vessels and can lead to kidney disease and anemia. It requires prompt treatment to prevent organ damage.
• Goodpasture Syndrome: An autoimmune disease that specifically targets the kidneys and lungs, causing nephritis and potentially leading to severe anemia. It is crucial to diagnose and treat early to prevent irreversible damage.

Rare Diagnoses

• Cold Agglutinin Disease: A rare autoimmune disorder where the immune system produces antibodies that attack red blood cells at low temperatures, leading to hemolytic anemia. It can be associated with infectious diseases or lymphoproliferative disorders and, in rare cases, might co-occur with nephritis.
• Paroxysmal Nocturnal Hemoglobinuria (PNH): A rare, acquired, life-threatening disease of the blood characterized by the destruction of red blood cells (hemolytic anemia), bone marrow failure, and the potential for blood clot formation. While primarily known for its hematologic manifestations, PNH can occasionally present with kidney issues, including nephritis.