Supporting Hours : Monday to Saturday - 8am to 10pm

A 46-year-old woman presents with fatigue and is found to have iron deficiency

46 years old | Female

Vignette:

A 46-year-old woman presents with fatigue and is found to have iron deficiency with anemia. She has experienced intermittent episodes of mild diarrhea for many years, previously diagnosed as irritable bowel syndrome and lactose intolerance. She has no current significant gastrointestinal symptoms such as diarrhea, bloating, or abdominal pain. Examination reveals 2 oral aphthous ulcers and pallor. Abdominal examination is normal and results of fecal testing for occult blood are negative.

Summary:

fatigue | iron deficiency | anemia | intermittent diarrhea | many years | irritable bowel syndrome | lactose intolerance | oral aphthous ulcers | pallor

Dx:

Celiac disease

Ref:

https://online.epocrates.com/diseases/63622/Celiac-disease/Common-Vignette

Rank

Disease

Weight

1 Systemic lupus erythematosus 306.0
2 Crohn Disease 249.0
3 Celiac Disease 242.0
4 Ulcerative Colitis 233.0
5 Hemolytic uremic syndrome 232.0
6 Acute Myeloid Leukemia in adults 222.0
7 Lactose intolerance 212.0
8 Sarcoidosis 208.0
9 Multiple Myeloma 205.0
10 Brucellosis 200.0
11 Systemic sclerosis 190.0
12 Abetalipoproteinemia 178.0
13 Addison Disease 176.0
14 Klebsiella pneumoniae liver abscess 173.0
15 Pyogenic Liver Abscess 172.0
16 Multiple Sclerosis 169.0
17 Chronic heart failure 169.0
18 Giardiasis 169.0
19 Irritable Bowel Syndrome 169.0
20 Food poisoning 165.0
21 Biliary cirrhosis 163.0
22 Renal and perinephric abscess 163.0
23 Primary biliary cirrhosis 161.0
24 Alcoholic Liver Disease 160.0
25 Analgesic nephropathy 156.0
26 Acute Lymphocytic Leukemia in Adults 156.0
27 Hypothyroidism 153.0
28 Secondary hyperparathyroidism 151.0
29 Toxic Megacolon 148.0
30 Acute Myeloid Leukemia in children 148.0
31 Graves Disease 147.0
32 Abnormal uterine bleeding 146.0
33 Short bowel syndrome 146.0
34 Kawasaki disease 144.0
35 Liver Cirrhosis 143.0
36 Pheochromocytoma 143.0
37 Chronic pelvic pain in women 141.0
38 Alcoholic hepatitis 140.0
39 Alcoholic Fatty Liver 140.0
40 Alcoholic Liver Cirrhosis 140.0
41 Infectious mononucleosis 140.0
42 Mesenteric ischemia 139.0
43 Atopic dermatitis 138.0
44 Malaria 135.0
45 Amyloidosis 135.0
46 Renal Cell Carcinoma 134.0
47 Chronic Kidney Diseases 131.0
48 Fibromyalgia 130.0
49 posteriorischemic optic neuropathy 128.0
50 Non-small cell lung cancer 126.0
51 Acute Lymphoblastic leukemia in children 125.0
52 Primary sclerosing cholangitis 124.0
53 Non-cholera Vibrio infections 123.0
54 Endometrial cancer 121.0
55 Acute Hepatitis 119.0
56 Angiodysplasia of the colon 119.0
57 Osteoarthritis 118.0
58 Hypogammaglobulinemia 118.0
59 Autoimmune hepatitis 116.0
60 Primary Myelofibrosis 116.0
61 Peutz-Jeghers Syndrome 116.0
62 Viral pharyngitis 114.0
63 Salmonella infection 114.0
64 Diverticulitis 110.0
65 Prolactinoma 109.0
66 Obstructive Sleep Apnea 108.0
67 Type 1 Diabetes mellitus 106.0
68 Stevens-Johnson syndrome 106.0
69 Chronic Hepatitis 104.0
70 mucosal Eosinophilic gastroenteritis 104.0
71 Rheumatoid Arthritis 104.0
72 Liver disease 103.0
73 Non-ST-elevation myocardial infarction 103.0
74 Recurrent aphthous stomatitis 101.0
75 Anaphylaxis 100.0
76 Bacterial pharyngitis 99.0
77 ST-elevation myocardial infarction 99.0
78 Amebic Liver Abscess 98.0
79 Gastritis 98.0
80 Chronic pyelonephritis 98.0
81 Foodborne E coli infection 98.0
82 Acute Mitral regurgitation 96.0
83 Chronic Myeloid Leukemia 96.0
84 Intestinal Entamoeba histolytica amebiasis 96.0
85 Chronic Lymphocytic Leukemia 95.0
86 Chronic Mitral regurgitation 94.0
87 Premenstrual syndrome 93.0
88 Acute bacterial meningitis in neonates 93.0
89 Cystic Fibrosis 92.0
90 Chronic bacterial prostatitis 91.0
91 Psoas Abscess 90.0
92 Viral Gastroenteritis 88.0
93 STI HIV Pharyngitis 85.0
94 Hereditary Angioedema 84.0
95 Acne fulminans 84.0
96 Rocky Mountain spotted fever 84.0
97 Non-diabetic hypoglycemia 84.0
98 Adrenal crisis 83.0
99 Polyarteritis nodosa 83.0
100 Colorectal cancer 82.0
101 Gastrointestinal Hemorrhage 82.0
102 Lower gastrointestinal hemorrhage 82.0
103 Upper gastrointestinal hemorrhage 82.0
104 Diabetic Ketoacidosis 82.0
105 Chronic fatigue syndrome 82.0
106 pancreatic cancer 81.0
107 Diabetic Kidney Disease 81.0
108 Autoimmune Pancreatitis 80.0
109 Hyperthyroidism 80.0
110 Graves ophthalmopathy 80.0
111 Atypical pneumonia 80.0
112 Premature labor 80.0
113 Bacterial gastroenteritis 79.0
114 Goiter 79.0
115 Diffuse nontoxic goiter 79.0
116 Obstructive cervical goiters 79.0
117 Cervical goiter 79.0
118 Familial adenomatous polyposis syndrome 79.0
119 Aortic stenosis 78.0
120 Stable angina 77.0
121 Acute viral meningitis 77.0
122 Acromegaly 76.0
123 Toxic multinodular goiter 75.0
124 Motion Sickness 75.0
125 Hereditary hemochromatosis 73.0
126 Choledocholithiasis 72.0
127 Autosomal Dominant Polycystic Kidney Disease 72.0
128 Aseptic meningitis 72.0
129 Duodenal Ulcer 71.0
130 Gastric Ulcer 71.0
131 Allergic rhinitis 71.0
132 Painless thyroiditis 71.0
133 Sunburn 71.0
134 Aortic coarctation 71.0
135 End Stage Renal Disease 70.0
136 Migraine 70.0
137 Liver Abscess 69.0
138 Hyperprolactinemia 68.0
139 Cholera 68.0
140 Intestinal Pseudo Obstruction 68.0
141 Acute perforated appendicitis 67.0
142 Adrenocortical carcinoma 67.0
143 Granulomatosis with polyangiitis 67.0
144 Central hypothyroidism 67.0
145 Shigellosis 67.0
146 Inflammatory Bowel Diseases 66.0
147 Mitral Stenosis 66.0
148 Lung Cancer 66.0
149 Migraine headache in adults 66.0
150 Balanitis 65.0
151 Gilbert syndrome 65.0
152 Tinnitus 65.0
153 Non-alcoholic Fatty Liver Disease 64.0
154 Pneumonia 64.0
155 Thrombotic thrombocytopenic purpura 64.0
156 Familial Mediterranean fever 64.0
157 Autoimmune hemolytic anemia 63.0
158 Spontaneous bacterial peritonitis 63.0
159 Pharyngitis 63.0
160 Herpes pharyngitis 63.0
161 chronic acalculous cholecystitis 63.0
162 Acute Rhinosinusitis 63.0
163 Insomnia in adults 63.0
164 Acute viral rhinosinusitis 63.0
165 Endometriosis 62.0
166 Listerial gastroenteritis 62.0
167 Hemorrhagic stroke 62.0
168 Ischemic stroke 62.0
169 Toxic thyroid adenoma 62.0
170 Ischemic optic neuropathy 61.0
171 anterior ischemic optic neuropathy 61.0
172 Primary hypogonadism 61.0
173 Secondary hypogonadism 61.0
174 Peritoneal dialysis associated peritonitis 60.0
175 Stable ischemic heart disease 60.0
176 Chronic Pancreatitis 59.0
177 Ovarian Cancer 59.0
178 Acetaminophen overdose 59.0
179 Erectile dysfunction 59.0
180 Muscle Layer Eosinophilic gastroenteritis 58.0
181 Eosinophilic gastroenteritis 58.0
182 Parkinson disease 58.0
183 cholestatic liver disease 57.0
184 Adrenal Suppression 57.0
185 Cholangiocarcinoma 56.0
186 subserosal eosinophilic gastroenteritis 56.0
187 COPD Exacerbation 56.0
188 Hyperparathyroidism 55.0
189 Churg-Strauss Syndrome 55.0
190 Cryptococcosis 55.0
191 Kartagener syndrome 55.0
192 Acute bacterial rhinosinusitis 55.0
193 Multiple endocrine neoplasia 2A 55.0
194 Varicose veins 55.0
195 Ankylosing spondylitis 54.0
196 Malt lymphoma 54.0
197 Gastric Outlet Obstruction 54.0
198 Priapism 54.0
199 Oropharyngeal cancer 54.0
200 Animal bites 54.0
201 Hypercalcemia 53.0
202 Multiple endocrine neoplasia 2B 53.0
203 Tuberculous Peritonitis 52.0
204 Primary ciliary dyskinesia 52.0
205 Mallory-Weiss syndrome 52.0
206 Zollinger-Ellison Syndrome 51.0
207 Leiomyomas 51.0
208 Hyperaldosteronism 51.0
209 Acute bacterial meningitis in children 51.0
210 Esophagitis 51.0
211 Acute Pancreatitis 51.0
212 Acute fatty liver of pregnancy 50.0
213 Unstable angina 50.0
214 Osteoporosis 50.0
215 Ruptured Tuboovarian abscess 49.0
216 Acute Appendicitis 48.0
217 Acute otitis media 48.0
218 Type 2 Diabetes mellitus 48.0
219 Extraintestinal Entamoeba histolytica amebiasis 48.0
220 Gastric Volvulus 48.0
221 Gastric cancer 46.0
222 Asthma 46.0
223 Diabetic Amyotrophy 46.0
224 Limited cutaneous systemic sclerosis 46.0
225 Acute bacterial meningitis in adults 45.0
226 Anthrax 45.0
227 Henoch-Schonlein purpura 45.0
228 Endometritis 44.0
229 Amphetamine use disorder 44.0
230 Ovarian and fallopian tube torsion 44.0
231 Anal Fissure 44.0
232 Chronic Clonorchiasis 43.0
233 Secondary Peritonitis 43.0
234 Acute peptic ulcer 43.0
235 Chronic atrial fibrillation 43.0
236 Nasal polyps 43.0
237 Gastroenteritis 43.0
238 Acute Liver Failure 42.0
239 chronic cholestatic liver disease 42.0
240 Influenza 41.0
241 Croup 41.0
242 Bullous pemphigoid 41.0
243 Gallbladder cancer 40.0
244 Bladder Cancer 40.0
245 Milk-alkali syndrome 40.0
246 Acute Milk-alkali syndrome 40.0
247 Chronic Milk-alkali syndrome 40.0
248 Meckel diverticulum 40.0
249 Glomerulonephritis 39.0
250 Stroke 39.0
251 Anemia of chronic disease 39.0
252 Acute respiratory failure 39.0
253 Hypoparathyroidism 38.0
254 Cushing syndrome 38.0
255 Menopause 38.0
256 Hepatorenal Syndrome 37.0
257 Intra-abdominal abscess 37.0
258 Intestinal Obstruction 36.0
259 Hemorrhoids 36.0
260 Intussusception 36.0
261 Gallstone pancreatitis 36.0
262 Wilson disease 35.0
263 COVID19 35.0
264 Subdural hematoma 35.0
265 Acute Cholecystitis 34.0
266 Emphysematous cholecystitis 34.0
267 Acute disseminated encephalomyelitis 33.0
268 Eclampsia 33.0
269 Typhoid infection 33.0
270 Labyrinthitis 33.0
271 Acute Clonorchiasis 32.0
272 Pancreatic Pseudocyst 32.0
273 Annular pancreas 32.0
274 Anaplastic thyroid cancer 32.0
275 Systemic vasculitis 32.0
276 Herpes zoster 31.0
277 Empyema 31.0
278 Autosomal Recessive Polycystic Kidney Disease 31.0
279 Campylobacter infection 31.0
280 Peptic Ulcer 31.0
281 Oral candidiasis 31.0
282 Ascites 30.0
283 Acute peritonitis 30.0
284 Male factor infertility 30.0
285 Exocrine pancreatic insufficiency 30.0
286 Renal Artery Stenosis 29.0
287 Cellulitis 29.0
288 Amebiasis 29.0
289 Hepatocellular carcinoma 28.0
290 Psoriasis 28.0
291 Rotor syndrome 28.0
292 Travelers diarrhea 28.0
293 Acute pyelonephritis in adults 27.0
294 Gastroparesis 27.0
295 Ovarian Torsion 26.0
296 Fungal meningitis 26.0
297 Pelvic inflammatory disease 25.0
298 Acute pelvic inflammatory disease 25.0
299 Laryngeal Cancer 25.0
300 Periorbital and orbital cellulitis 24.0
301 Foreign body ingestion 24.0
302 Diabetes Mellitus 24.0
303 Abdominal compartment syndrome 23.0
304 Acute Bacterial Prostatitis 23.0
305 Acute pericarditis 23.0
306 Rumination Syndrome 23.0
307 Acute intermittent porphyria 22.0
308 Ovarian Hyperstimulation Syndrome 22.0
309 Hyperosmolar Hyperglycemic state 22.0
310 Gallbladder Empyema 21.0
311 Hepatic Encephalopathy 20.0
312 Genital herpes 20.0
313 Charcot-Marie-Tooth Disease 20.0
314 Ruptured ectopic pregnancy 20.0
315 Splenic Rupture 20.0
316 Gallbladder Dyskinesia 20.0
317 Sphincter of Oddi Dysfunction 20.0
318 biliary SOD 20.0
319 pancreatic SOD 20.0
320 Papilledema 20.0
321 Chronic meningitis 20.0
322 Osteomalacia 20.0
323 biliary colic 19.0
324 Pyelonephritis 19.0
325 Acalculous Cholecystitis 18.0
326 Musculoskeletal sprains and strains 18.0
327 Thyroid lymphoma 18.0
328 Insect bites and stings 18.0
329 Gallstones 18.0
330 Meniere disease 18.0
331 Medullary thyroid cancer 18.0
332 Hypertriglyceridemia 17.0
333 Angle Closure Glaucoma 17.0
334 Budd Chiari Syndrome 16.0
335 Pseudohypoparathyroidism 16.0
336 Alzheimer disease 16.0
337 Clostridium difficile infection 16.0
338 Disseminated intravascular coagulation 16.0
339 Inguinal hernia 16.0
340 Acne vulgaris 16.0
341 Acne conglobata 16.0
342 Gram-negative folliculitis 16.0
343 Excoriated acne 16.0
344 Aortic Dissection 15.0
345 Common cold(adults) 15.0
346 Bacterial conjunctivitis 15.0
347 Viral conjunctivitis 15.0
348 Substernal goiter 15.0
349 Kidney stones 15.0
350 Dystonia 15.0
351 Tetanus 15.0
352 Panic disorder in adults 15.0
353 Rotator Cuff Tears 14.0
354 Nephrogenic diabetes insipidus 14.0
355 Central diabetes insipidus 14.0
356 Psychogenic polydipsia 14.0
357 Gingivitis 14.0
358 Miliaria 14.0
359 Gout 14.0
360 Dyspepsia 14.0
361 Ileus 14.0
362 Optic neuritis 13.0
363 Neuropapillitis 13.0
364 Chlamydia pneumoniae infection 13.0
365 Splenic Infarction 13.0
366 Intrahepatic cholestasis of pregnancy 13.0
367 Preeclampsia 13.0
368 Clonorchiasis 12.0
369 Chronic liver disease 12.0
370 Portal hypertension 12.0
371 Gastroesophageal reflux disease 12.0
372 Achalasia 12.0
373 Urinary Tract Obstruction 12.0
374 Osteomyelitis 12.0
375 Intestinal malrotation 12.0
376 Heparin-induced thrombocytopenia 11.0
377 Benign Prostatic Hyperplasia 11.0
378 Deep venous thrombosis 11.0
379 Pulmonary Embolism 10.0
380 Hiatus hernia 10.0
381 Guillain-Barre syndrome 10.0
382 Drowning 9.0
383 Acute atrial fibrillation 9.0
384 Peritonitis 9.0
385 Prinzmetal angina 9.0
386 Acute heart failure 9.0
387 Acute Cholangitis 8.0
388 Paraneoplastic Syndromes 7.0
389 Common cutaneous drug reactions 7.0
390 Common cold(children) 6.0
391 Epiploic appendagitis 6.0
392 Umbilical hernia 6.0
393 Mitral Valve Prolapse 6.0
394 Pityriasis rosea 5.0
395 Bed bugs 5.0
396 Barrett esophagus 5.0
397 Acute Bronchitis 4.0
398 Alopecia areata 4.0
399 Sigmoid volvulus 4.0
400 Testicular cancer 4.0
401 Acute Cystitis(Men) 0.0
402 Carpal Tunnel Syndrome 0.0
403 Bell palsy 0.0
404 Penis Carcinoma 0.0
405 Discogenic low back pain 0.0
406 Immune thrombocytopenia 0.0
407 Orthostatic hypotension 0.0
408 Pulmonary regurgitation 0.0
409 Musculoskeletal lower back pain 0.0
410 Acute epididymitis 0.0
411 Transient ischemic attack 0.0
412 Psoriatic arthritis 0.0