Differential Diagnosis for 57-year-old Male with Bilateral Leg Weakness and Complex Medical History
Single Most Likely Diagnosis
- Diabetic Neuropathy: Given the patient's history of poorly controlled diabetes mellitus type 2, bilateral leg weakness is a common symptom of diabetic neuropathy, which can cause numbness, weakness, and pain in the legs.
Other Likely Diagnoses
- Vitamin B12 Deficiency: The patient's history of GERD and poor adherence to medical care may contribute to a vitamin B12 deficiency, which can cause leg weakness, anemia, and neurological symptoms.
- Chronic Kidney Disease-Related Neuropathy: The patient's chronic kidney disease can cause neuropathy, leading to leg weakness, numbness, and pain.
- Hypothyroidism-Related Myopathy: Hypothyroidism can cause muscle weakness, including leg weakness, due to thyroid hormone deficiency.
- Alcohol Withdrawal-Related Neuropathy: Although the patient reports recent alcohol cessation, alcohol withdrawal can cause neuropathy, leading to leg weakness.
Do Not Miss Diagnoses
- Spinal Cord Compression: A potentially life-threatening condition that can cause bilateral leg weakness, spinal cord compression requires prompt diagnosis and treatment to prevent permanent damage.
- Guillain-Barré Syndrome: An autoimmune disorder that can cause rapid onset of leg weakness, Guillain-Barré syndrome is a medical emergency that requires immediate attention.
- Multiple Myeloma: A type of blood cancer that can cause leg weakness, multiple myeloma is a potentially life-threatening condition that requires prompt diagnosis and treatment.
Rare Diagnoses
- Amyotrophic Lateral Sclerosis (ALS): A rare neurodegenerative disorder that can cause progressive leg weakness, ALS is a diagnosis of exclusion that requires thorough evaluation and testing.
- Lyme Disease: A rare infectious disease that can cause leg weakness, Lyme disease is typically associated with a distinctive rash and requires prompt diagnosis and treatment.
- Sarcoidosis: A rare autoimmune disorder that can cause leg weakness, sarcoidosis can affect multiple organs and requires thorough evaluation and testing.