Differential Diagnosis for 37 YOF with Thinning of Hair and Increased Hearing Loss

Single Most Likely Diagnosis

• Alopecia and Presbycusis: This combination could be attributed to early onset of age-related hearing loss (presbycusis) and female pattern hair loss (alopecia), which are common conditions. The justification for this being the most likely diagnosis is the prevalence of these conditions in the general population and their potential to present in a relatively young individual.

Other Likely Diagnoses

• Autoimmune Disorders (e.g., Alopecia Areata, Rheumatoid Arthritis): These conditions can cause hair loss and may be associated with hearing loss due to inflammation or autoimmune damage to the auditory system.
• Hypothyroidism: This condition can lead to hair loss and has been associated with hearing impairment. The metabolic changes caused by hypothyroidism can affect both hair growth and auditory function.
• Vitamin Deficiencies (e.g., Vitamin B12, Iron): Deficiencies in certain vitamins and minerals can lead to hair loss and have been linked to hearing loss, possibly due to the role these nutrients play in maintaining healthy nerve cells and blood supply.

Do Not Miss Diagnoses

• Systemic Lupus Erythematosus (SLE): Although less common, SLE is a serious autoimmune disease that can cause hair loss and hearing loss among its myriad of symptoms. Missing this diagnosis could lead to significant morbidity and mortality if not treated promptly.
• Sjögren's Syndrome: This autoimmune disorder can cause dryness in the eyes and mouth but can also be associated with hair loss and hearing loss. It's crucial not to miss this diagnosis due to its potential to cause significant discomfort and its association with other serious autoimmune conditions.
• Cancer (e.g., Lymphoma): Certain types of cancer, particularly those affecting the lymphatic system, can cause both hair loss (due to chemotherapy or the disease itself) and hearing loss (due to direct involvement of the auditory system or as a side effect of treatment).

Rare Diagnoses

• Werner Syndrome: A rare genetic disorder characterized by premature aging, which can include hair loss and hearing loss among its symptoms.
• Marshall Syndrome: A rare genetic disorder that affects the development of the ears, eyes, and other parts of the body, potentially leading to hearing loss and could be associated with hair loss in some cases.
• Congenital Syphilis: Although rare in developed countries due to prenatal screening, congenital syphilis can cause a variety of symptoms including hearing loss and potentially hair loss, making it a rare but important consideration in the differential diagnosis.