Differential Diagnosis

The patient's laboratory results indicate elevated CRP, creatinine, and urate levels, with a decreased eGFR. These findings suggest an inflammatory process, renal impairment, and possible gout. Here's a categorized differential diagnosis:

• Single most likely diagnosis
  • Chronic Kidney Disease (CKD): The elevated creatinine level (100 umol/L) and decreased eGFR (55 mL/min/1.73m2) strongly suggest CKD. The patient's age and elevated urate level also support this diagnosis.
• Other Likely diagnoses
  • Gout: The elevated urate level (0.57 mmol/L) is a significant finding, and the patient's age and renal impairment increase the likelihood of gout.
  • Hypertension: Although not directly measured, the patient's renal impairment and elevated urate level may be related to uncontrolled hypertension.
  • Atherosclerotic Cardiovascular Disease: The patient's age, elevated CRP, and renal impairment increase the risk of atherosclerotic cardiovascular disease.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Sepsis: Although the patient's WBC count is within normal limits, the elevated CRP level (44 mg/L) could indicate a underlying infection. Sepsis is a life-threatening condition that requires prompt recognition and treatment.
  • Malignancy: The elevated platelet count (438 x 10e9/L) and CRP level may be indicative of an underlying malignancy, such as a hematologic or solid tumor cancer.
• Rare diagnoses
  • Amyloidosis: The patient's renal impairment and elevated urate level could be related to amyloidosis, a rare condition characterized by the deposition of abnormal proteins in organs and tissues.
  • Multiple Myeloma: The elevated CRP level and renal impairment may be associated with multiple myeloma, a rare hematologic malignancy. However, the lack of other specific findings (e.g., anemia, hypercalcemia) makes this diagnosis less likely.