Differential Diagnosis for a 13-month-old with Hgb 12.7 and Iron Saturation of 11

• Single Most Likely Diagnosis
  • Iron Deficiency Anemia (IDA): This is the most likely diagnosis given the low iron saturation level. At 13 months, children are at high risk for IDA due to increased demand for iron during rapid growth and development, and potentially inadequate dietary intake.
• Other Likely Diagnoses
  • Anemia of Chronic Disease: Although less likely than IDA, anemia of chronic disease could present with similar lab findings, especially if the child has an underlying chronic condition.
  • Thalassemia Trait: This could be a consideration, especially if there's a family history, but the iron saturation level would typically be expected to be higher or more variable.
• Do Not Miss Diagnoses
  • Lead Poisoning: Although the primary concern with lead poisoning is neurodevelopmental toxicity, it can also cause anemia. Given the critical importance of early detection and treatment, lead poisoning must be considered, especially in children at risk (e.g., those living in older homes with lead-based paint).
  • Chronic Infection or Inflammatory Conditions: Conditions like tuberculosis or chronic infections can cause anemia of chronic disease. Missing these diagnoses could have significant implications for the child's health.
• Rare Diagnoses
  • Sideroblastic Anemia: A rare condition characterized by the accumulation of iron in the mitochondria of red blood cell precursors, leading to anemia and often increased iron stores, which might not fit perfectly with the low iron saturation but could be considered in complex cases.
  • Congenital Disorders of Iron Metabolism: These are rare conditions that affect how the body processes iron, potentially leading to anemia or other complications. They would be considered if common causes are ruled out and there are suggestive clinical or family history findings.