Differential Diagnosis for Iron Deficiency Anemia

Given the laboratory results: UIBC 478, Iron Sat 10, TIBC 533, and Hgb 12, we can categorize the differential diagnosis as follows:

• Single Most Likely Diagnosis

  • Iron Deficiency Anemia: This is the most likely diagnosis due to the low iron saturation (10%), elevated Total Iron-Binding Capacity (TIBC), and low hemoglobin (Hgb) level. The high Unbound Iron-Binding Capacity (UIBC) also supports this diagnosis, indicating insufficient iron to bind with transferrin.

• Other Likely Diagnoses

  • Anemia of Chronic Disease: Although less likely than iron deficiency anemia given the high TIBC, anemia of chronic disease can present with low iron saturation. However, TIBC is typically low or normal in this condition, making it less likely here.
  • Thalassemia: Some forms of thalassemia can present with mild anemia and alterations in iron studies, though the pattern here is more suggestive of iron deficiency.

• Do Not Miss Diagnoses

  • Gastrointestinal Bleeding: A source of chronic blood loss could lead to iron deficiency anemia. Missing this diagnosis could lead to significant morbidity or mortality if the underlying cause (e.g., ulcer, cancer) is not addressed.
  • Celiac Disease: This condition can lead to malabsorption of iron, resulting in deficiency over time. It's crucial not to miss this diagnosis due to its potential for significant morbidity if left untreated.

• Rare Diagnoses

  • Pregnancy-Related Anemia: In pregnant women, the demand for iron increases, which can lead to iron deficiency anemia if not adequately supplemented.
  • Chronic Kidney Disease: Can lead to anemia, but the iron studies would more typically show a different pattern, such as elevated ferritin with low iron saturation.
  • Hemoglobinopathies (other than thalassemia): Certain hemoglobinopathies can present with anemia and abnormal iron studies, though they are less common and would typically have other distinguishing features.