Pathophysiologic Process of Anemia
1) Is What the diagnosis you believe to be correct for this patient.
2) Describe the pathophysiologic process of Anemia. Identify two differential diagnoses and provide the pathophysiology of these two differential diagnoses.
3) Identify the additional workup that is needed to rule in or rule out these differential diagnoses.
4) What clinical signs/symptoms would you expect to see with these two differential diagnoses?
The patient information, symptoms, and laboratory test results indicate iron deficiency anemia (IDA). IDA is the most common type of anemia and can occur at any life stage. Hence, without additional clinical data to consider other types of anemia or illnesses, it is the correct diagnosis.
Iron is critical to the formation of healthy red blood cells. Thus, when the body depletes its iron reserves, the production of healthy RBCs ceases. The depletion may occur due to not consuming enough of it in one’s diet, poor iron absorption in the body, or bleeding (Harper, 2021).
Some appropriate differential diagnoses for the patient include aplastic anemia and hemolytic anemia. Aplastic anemia occurs following damage to stem cells in the bone marrow, the production hub of red blood cells (Bakhshi, 2021). The damage mainly arises from autoimmune illnesses targeting the bone marrow. Meanwhile, hemolytic anemia occurs when the body destroys too many red blood cells (hemolysis) prematurely, causing low RBC numbers (Nagalla, 2021). Genetic factors, sickle cell disease, and infections can cause excessive hemolysis.
A bone marrow biopsy would provide information to determine whether the patient has aplastic anemia or IDA. Aplastic anemia will become the primary diagnosis if the biopsy reveals abnormal or damaged stem cells. On the other hand, lactate dehydrogenase (LDH), haptoglobin, and unconjugated bilirubin tests would be essential additional workups to rule out/in hemolytic anemia. An abnormal hemolytic rate would signify that hemolytic anemia is the correct diagnosis instead of IDA.
The two differential diagnoses have hugely similar symptoms to IDA. For instance, aplastic anemia causes fatigue, long-lasting infections, and easy bruising and bleeding. Hemolytic anemia causes pallor, palpitations, jaundice, confusion, and spleen/liver enlargement. Thus, clinical observations are not sufficient to effectively rule out any of the possible diagnoses.
Bakhshi, S. (2021, Jan. 29). Aplastic Anemia. https://emedicine.medscape.com/article/198759-overview
Harper, J. L. (2021, Oct. 01). Iron Deficiency Anemia. https://emedicine.medscape.com/article/202333-overview#a2
Nagalla, S. (2021, Sep. 09). Hemolytic Anemia. https://emedicine.medscape.com/article/201066-overview