Differential Diagnosis for a 10-year-old child with positive lactoferrin
- Single most likely diagnosis
- Inflammatory Bowel Disease (IBD): A positive lactoferrin test is often indicative of intestinal inflammation, which is a hallmark of IBD, including conditions like Crohn's disease and ulcerative colitis. The negative tests for H. pylori and ova and parasites help to rule out other common causes of gastrointestinal symptoms, making IBD a leading consideration.
- Other Likely diagnoses
- Irritable Bowel Syndrome (IBS): Although lactoferrin is more specific for inflammatory conditions, some patients with IBS may have elevated levels, especially if there's an overlap with inflammatory processes or if the test is not perfectly specific.
- Celiac Disease: This autoimmune disorder can cause inflammation in the small intestine and potentially lead to a positive lactoferrin test. It's an important consideration, especially if the child has been experiencing chronic gastrointestinal symptoms.
- Infectious Gastroenteritis: Certain bacterial infections (other than H. pylori, which was tested and found to be negative) could potentially cause a positive lactoferrin due to the inflammatory response they provoke.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Intussusception: Although more commonly associated with abdominal pain and a specific type of stool, intussusception can cause intestinal inflammation and potentially a positive lactoferrin test. It's a medical emergency that requires prompt diagnosis and treatment.
- Appendicitis: Inflammation of the appendix can lead to elevated lactoferrin levels. Appendicitis is a surgical emergency, making its prompt diagnosis crucial.
- Rare diagnoses
- Eosinophilic Gastroenteritis: A rare condition characterized by the presence of eosinophils in the gastrointestinal tract, leading to inflammation. It could potentially cause a positive lactoferrin test.
- Vasculitis (e.g., Henoch-Schönlein Purpura): Systemic vasculitis can involve the gastrointestinal tract, leading to inflammation and potentially positive lactoferrin levels.
- Lymphoma or other malignancies: Although extremely rare in children, certain gastrointestinal malignancies could cause chronic inflammation and a positive lactoferrin test.