Differential Diagnosis
The provided lab results show an elevated glucose level, slightly elevated white blood cell count (WBC), and other parameters within relatively normal limits. Based on these results, the differential diagnosis can be categorized as follows:
Single Most Likely Diagnosis
- Diabetes Mellitus: The glucose level of 200 mg/dL is significantly elevated, suggesting diabetes mellitus as the most likely diagnosis. The slightly elevated WBC could be a response to the hyperglycemic state or an underlying infection, which is common in diabetic patients due to their impaired immune response.
Other Likely Diagnoses
- Infection: The elevated WBC count (11.5 x 10^9/L) could indicate an underlying infection. Although the absolute neutrophil count is not significantly elevated, it's essential to consider infection, especially in the context of hyperglycemia, which can impair immune function.
- Stress Response: A stress response, possibly due to a non-infectious cause like trauma, surgery, or severe illness, could also lead to elevated glucose and WBC levels.
Do Not Miss Diagnoses
- Sepsis: Although the WBC count is not dramatically elevated, sepsis is a life-threatening condition that must be considered, especially if the patient shows signs of infection or systemic inflammatory response syndrome (SIRS). Early recognition and treatment of sepsis are crucial.
- Acute Pancreatitis: Hyperglycemia can be seen in acute pancreatitis, and while the bilirubin is not significantly elevated, pancreatitis can cause a range of liver function test abnormalities. This diagnosis is critical to consider due to its potential severity.
Rare Diagnoses
- Cushing's Syndrome: This endocrine disorder can cause hyperglycemia due to excess cortisol production. It's a rare condition but should be considered in the differential diagnosis of unexplained hyperglycemia.
- Pheochromocytoma: Although rare, pheochromocytoma can cause episodes of hyperglycemia due to excess catecholamine release. It's an important diagnosis to consider due to its potential for severe cardiovascular complications.