Differential Diagnosis for Low Ferritin, Low Iron, and Normal TIBC
Single Most Likely Diagnosis
- Iron Deficiency Anemia (IDA): This is the most likely diagnosis given the low ferritin and low iron levels. Ferritin reflects the body's iron stores, and low levels indicate depletion of these stores. IDA is a common condition, often due to chronic blood loss, inadequate dietary intake, or increased iron requirement.
Other Likely Diagnoses
- Chronic Disease: Conditions like chronic infections, inflammation, or malignancies can lead to low iron levels despite normal TIBC, due to the body's prioritization of iron for immune functions and the production of hepcidin, which reduces iron absorption.
- Pregnancy: Pregnancy increases the demand for iron, and if this demand is not met through diet or supplements, it can lead to low iron levels. Ferritin levels can also be low due to the expanded blood volume and increased iron requirements for the fetus.
Do Not Miss Diagnoses
- Celiac Disease: An autoimmune disorder that can lead to malabsorption of nutrients, including iron. It's crucial to consider this diagnosis to avoid missing a treatable cause of iron deficiency anemia.
- Gastric Cancer: Though rare, gastric cancer can cause iron deficiency anemia due to chronic blood loss or malabsorption. It's a diagnosis that should not be missed due to its severe implications.
- Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis can lead to chronic blood loss and malabsorption, resulting in low iron levels.
Rare Diagnoses
- Atransferrinemia: A rare genetic disorder characterized by the absence or very low levels of transferrin, a protein that binds iron in the blood. This condition can lead to low iron levels despite normal TIBC.
- Hemoglobinopathies: Certain hemoglobinopathies, like thalassemia, can affect iron metabolism and lead to abnormal iron studies, though this would typically be accompanied by other hematological abnormalities.