Sickle-cell disease differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Shyam Patel [2]

Overview

In some cases, it can be difficult to differentiate sickle cell disease from other diagnoses, given that there may be significant overlap of symptoms.[1]

Differential Diagnosis

  • The differential diagnosis of sickle cell disease includes other conditions that may present with fatigue, infection, bone pain, such as:

Sickle cell disease must be differentiated from other causes of diabetes insipidus.

Type of DI Subclass Disease Defining signs and symptoms Lab/Imaging findings
Central Acquired Histiocytosis
  • CD1a and CD45 +
  • Interleukin-17 (ILITA)
Skull x-ray of a patient with Langerhan's histiocytosis showing lytic lesions - Case courtesy of Dr Hani Salam, Radiopaedia.org, rID: 9459
Craniopharyngioma
Brain MRI showing suprasellar mass consistent with the diagnosis of craniopharyngioma - Case courtesy of A.Prof Frank Gaillard, Radiopaedia.org, rID: 16812
Sarcoidosis
Contrast-enhanced patches in a patient previously diagnosed with lung sarcoidosis - Case courtesy of A.Prof Frank Gaillard, Radiopaedia.org, rID: 10930
Congenital Hydrocephalus Dilated ventricles on CT and MRI
Obstructive hydrocephalus showing dilated lateral ventricles - Case courtesy of Dr Paul Simkin, Radiopaedia.org, rID: 30453
Wolfram Syndrome (DIDMOAD)
Nephrogenic Acquired Drug-induced (demeclocycline, lithium)
Hypercalcemia
  • Ca levels greater than 11 meq/L
Hypokalemia
  • K levels less than 3meq/L on CBC
Multiple myeloma
Skeletal survey in a patient with multiple myeloma showing multiple lytic lesions - Case courtesy of A.Prof Frank Gaillard, Radiopaedia.org, rID: 7682
Sickle cell disease
Blood film showing the sickle cells - By Dr Graham Beards - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=18421017
Primary polydipsia Psychogenic
Gestational diabetes insipidus
Diabetes mellitus
  • Elevated blood sugar levels >126
  • Elevated HbA1c > 6.5

References

  1. 1.0 1.1 Sankaran VG, Weiss MJ (2015). "Anemia: progress in molecular mechanisms and therapies". Nat Med. 21 (3): 221–30. doi:10.1038/nm.3814. PMC 4452951. PMID 25742458.
  2. Hernigou P, Daltro G, Flouzat-Lachaniette CH, Roussignol X, Poignard A (2010). "Septic arthritis in adults with sickle cell disease often is associated with osteomyelitis or osteonecrosis". Clin Orthop Relat Res. 468 (6): 1676–81. doi:10.1007/s11999-009-1149-3. PMC 2865595. PMID 19885711.
  3. Ghosh KN, Bhattacharya A (1992). "Gonotrophic nature of Phlebotomus argentipes (Diptera: Psychodidae) in the laboratory". Rev Inst Med Trop Sao Paulo. 34 (2): 181–2. PMID 1340034.



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