Differential Diagnosis for Elevated Ferritin and Colitis
- Single most likely diagnosis
- Inflammatory Bowel Disease (IBD): This includes conditions like Crohn's disease and ulcerative colitis. Elevated ferritin can be seen due to chronic inflammation, and colitis is a direct symptom of IBD. The chronic nature of the disease can lead to increased ferritin levels as an acute-phase reactant.
- Other Likely diagnoses
- Infectious colitis: Certain infections can cause both colitis and an increase in ferritin levels as part of the body's inflammatory response. Examples include bacterial, viral, or parasitic infections.
- Diverticulitis: This condition involves inflammation of the diverticula in the digestive tract and can cause colitis-like symptoms. The inflammation can lead to elevated ferritin levels.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Hemophagocytic Lymphohistiocytosis (HLH): Although rare, HLH is a life-threatening condition that can present with elevated ferritin levels (often very high) and can involve the gastrointestinal system, potentially causing colitis. It's crucial to consider HLH due to its high mortality rate if untreated.
- Sepsis: In cases of severe infection, sepsis can occur, leading to elevated ferritin as part of the systemic inflammatory response syndrome (SIRS). Colitis could be a source of the infection leading to sepsis.
- Rare diagnoses
- Hereditary Hemochromatosis: A genetic disorder leading to excessive iron absorption, which can cause elevated ferritin levels. While it primarily affects the liver, pancreas, and heart, gastrointestinal symptoms can occur, though colitis is not a primary manifestation.
- Sarcoidosis: A condition characterized by the growth of granulomas in various parts of the body. It can cause elevated ferritin levels and, less commonly, gastrointestinal symptoms including colitis.