Differential Diagnosis for Low Ferritin in a 78-year-old Female
Single Most Likely Diagnosis
- Chronic Disease or Inflammation: Given the patient's age and normal hemoglobin, hematocrit, and MCV, a chronic disease or inflammation is the most likely cause of low ferritin. Chronic diseases such as arthritis, chronic infections, or malignancies can lead to low ferritin levels due to inflammation.
Other Likely Diagnoses
- Dietary Iron Deficiency: Although the patient's hemoglobin and hematocrit are normal, dietary iron deficiency could still be a contributing factor to low ferritin levels, especially if the patient has a poor diet or malabsorption.
- Chronic Kidney Disease: Chronic kidney disease can lead to inflammation and low ferritin levels, and is a common condition in elderly patients.
- Hypothyroidism: Hypothyroidism can cause low ferritin levels, and is more common in elderly females.
Do Not Miss Diagnoses
- Gastrointestinal Bleeding: Although the patient's hemoglobin and hematocrit are normal, gastrointestinal bleeding could still be a cause of low ferritin levels, and would be a critical diagnosis to miss.
- Malignancy: Certain malignancies, such as lymphoma or leukemia, can cause low ferritin levels, and would be a critical diagnosis to miss.
- Chronic Infections: Chronic infections such as tuberculosis or osteomyelitis can cause low ferritin levels, and would be a critical diagnosis to miss.
Rare Diagnoses
- Porphyria Cutanea Tarda: A rare genetic disorder that can cause low ferritin levels.
- Aceruloplasminemia: A rare genetic disorder that can cause low ferritin levels.
- Neurodegenerative Diseases: Certain neurodegenerative diseases, such as Parkinson's disease, can cause low ferritin levels, although this is a rare association.