Renal Anemia: Or something else? Differential Diagnosis

Blood, hematopoietic organs-immune system (D50-D90).

  • Aplastic anemia – form of anemia (anemia) characterized by pancytopenia (reduction of all cell series in the blood; stem cell disease) and concomitant hypoplasia (functional impairment) of the bone marrow.
  • Bleeding anemia, acute (source of bleeding: mainly genital or gastrointestinal/gastrointestinal tract).
  • Iron deficiency anemia (anemia due to iron deficiency).
  • Inflammatory anemia
  • Elliptocytosis – group of rare defects of the membrane skeleton of erythrocytes (red blood cells) with autosomal dominant or autosomal recessive inheritance; blood smear shows numerous elliptical erythrocytes (elliptocytes).
  • G6PD deficiency (glucose-6-phosphate dehydrogenase deficiency) – genetic disease with X-linked recessive inheritance; deficiency of the enzyme glucose-6-phosphate dehydrogenase leads to recurrent hemolysis and chronic anemia; about 13% of all male individuals from Central Africa: mild, clinically irrelevant form; people from Mediterranean countries and China: severe form.
  • Hemoglobinopathies (disorders of hemoglobin synthesis) of the β-globin chains (usually manifests in the 2nd year of life).
  • Hemolytic anemia – anemia (anemia) characterized by increased degradation or decay (hemolysis) of erythrocytes (red blood cells), which can no longer be compensated by increased production in the red bone marrow.
  • Megaloblastic anemia (pernicious anemia) – anemia (anemia) caused by a deficiency of vitamin B12 or, less commonly, folic acid deficiency.
  • Myelofibrosis (bone marrow fibrosis).
  • Runners Anemia – anemia (anemia caused by an increase in blood plasma volume and by increased hemolysis (dissolution of red blood cells) in runners.
  • Sickle cell anemia (med.: drepanocytosis; also sickle cell anemia, sickle cell anemia) – genetic disease with autosomal recessive inheritance, affecting erythrocytes (red blood cells); it belongs to the group of hemoglobinopathies (disorders of hemoglobin; formation of an irregular hemoglobin called sickle cell hemoglobin, HbS).
  • Spherocytosis (spherocytic anemia).
  • Thalassemia – autosomal recessive hereditary synthesis disorder of the alpha or beta chains of the protein portion (globin) in hemoglobin (hemoglobinopathy/diseases resulting from impaired formation of hemoglobin).
    • Α-Thalassemia (HbH disease, hydrops fetalis/generalized fluid accumulation); incidence: mostly in Southeast Asians.
    • Β-Thalassemia: most common monogenetic disorder worldwide; incidence: People from Mediterranean countries, Middle East, Afghanistan, India and Southeast Asia.
  • Tumor anemia

Endocrine, nutritional and metabolic diseases (E00-E90).

  • Iron utilization disorders
  • Hyperthyroidism (overactive thyroid gland)
  • Hypothyroidism (hypothyroidism)
  • Addison’s disease – primary adrenocortical insufficiency (adrenal cortical hypofunction), which mainly causes a failure of cortisol production, but also leads to a deficiency of mineralocorticoids (aldosterone).
  • Panhypopituitarism – disease that leads to a restriction or complete failure of all pituitary hormones (hormones of the pituitary gland).

Infectious and parasitic diseases (A00-B99).

  • Chronic inflammation, unspecified
  • Chronic infections, unspecified
  • Helminthiasis (worm diseases)
  • Malaria
  • Parvovirus B19-induced aplastic crisis in hemolytic anemias.
  • Viral infection-associated hemolytic crises in hemolytic anemias.

Liver, gallbladder, and bile ducts – Pancreas (pancreas) (K70-K77; K80-K87).

Mouth, esophagus (food pipe), stomach, and intestines (K00-K67; K90-K93).

Musculoskeletal system and connective tissue (M00-M99).

  • Chronic inflammatory diseases (eg, rheumatoid arthritis).

Neoplasms – tumor diseases (C00-D48).

  • Colon carcinoma (cancer of the large intestine)
  • Leukemia (blood cancer)
  • Gastric carcinoma (stomach cancer)
  • Hodgkin’s disease – malignant neoplasm (malignant neoplasm) of the lymphatic system with possible involvement of other organs. It is counted among the malignant lymphomas
  • Myelodysplastic syndrome (MDS) – acquired clonal disease of the bone marrow associated with a disorder of hematopoiesis (blood formation); defined by:
    • Dysplastic cells in the bone marrow or ring sideroblasts or an increase of myeloblasts up to 19%.
    • Cytopenias (decrease in the number of cells in the blood) in the peripheral blood count.
    • Exclusion of reactive causes of these cytopenias.

    One quarter of MDS patients develop acute myeloid leukemia (AML).

  • Plasmocytoma (multiple myeloma) – malignant (malignant) systemic disease, which is one of the non-Hodgkin lymphomas of B lymphocytes.
  • Leiomyomas (uterus myomatosus) – most common benign neoplasm of women, originating from the muscles (myoma) of the uterus (womb). The myomas are histologically (fine tissue) mostly leiomyomas.

Genitourinary system (kidneys, urinary tract – sex organs) (N00-N99).

  • Hypermenorrhea – increased menstruation (bleeding is too heavy (> 80 ml); usually the affected person consumes more than five pads/tampons per day).
  • Renal insufficiency – process leading to a slowly progressive reduction in kidney function.

Injury, poisoning, and other consequences of external causes (S00-T98).

  • Lead intoxication (lead poisoning).

Other differential diagnoses

  • Hemolytic crises in G6PD deficiency.
  • Gestational hydremia – dilutional anemia due to water retention in pregnancy.

Medication

  • See “Causes” under medications

Environmental pollution – intoxications (poisoning).

  • Arsenic
  • Benzene
  • Bismuth
  • Lead
  • Gold
  • Mercury