Differential Diagnosis

The patient's laboratory results indicate iron deficiency anemia, as evidenced by low ferritin, low iron, and low percent saturation. The presence of elevated thyroglobulin antibodies suggests autoimmune thyroiditis, but normal thyroid peroxidase antibodies may indicate a different autoimmune process or a non-specific elevation. The high sensitive reactive protein (CRP) level indicates inflammation.

• Single Most Likely Diagnosis
  • Iron deficiency anemia: The patient's low ferritin, low iron, and low percent saturation are all indicative of iron deficiency anemia. The high RDW (red cell distribution width) also supports this diagnosis, as it indicates a variation in red blood cell size, which is common in iron deficiency anemia.
• Other Likely Diagnoses
  • Chronic inflammation: The high CRP level suggests an underlying inflammatory process, which could be contributing to the patient's anemia. Chronic diseases such as rheumatoid arthritis, chronic infections, or malignancies could be the cause.
  • Autoimmune thyroiditis: Although thyroid peroxidase antibodies are normal, the elevated thyroglobulin antibodies may indicate autoimmune thyroiditis, which could be contributing to the patient's symptoms.
  • Anemia of chronic disease: The patient's laboratory results could also be consistent with anemia of chronic disease, which is characterized by low iron, low percent saturation, and elevated ferritin. However, the low ferritin level in this case makes this diagnosis less likely.
• Do Not Miss Diagnoses
  • Celiac disease: This condition can cause iron deficiency anemia due to malabsorption of iron. It is essential to consider this diagnosis, as it can have significant implications for the patient's management and treatment.
  • Hemoglobinopathy: Although the patient's hemoglobin level is normal, the low MCHC (mean corpuscular hemoglobin concentration) and high RDW could indicate a hemoglobinopathy, such as thalassemia.
  • Malignancy: The elevated CRP level and anemia could be indicative of an underlying malignancy, which would require prompt evaluation and treatment.
• Rare Diagnoses
  • Sideroblastic anemia: This rare condition is characterized by the presence of ringed sideroblasts in the bone marrow and can cause iron overload and anemia.
  • Paroxysmal nocturnal hemoglobinuria (PNH): This rare condition is characterized by the destruction of red blood cells and can cause anemia, thrombosis, and other complications.
  • Gastric bypass surgery or other malabsorptive conditions: These conditions can cause iron deficiency anemia due to malabsorption of iron.