Differential Diagnosis for Hiatus Hernia and ILD
- Single most likely diagnosis:
- Scleroderma: This autoimmune disease is known to cause both hiatus hernia due to esophageal dysmotility and interstitial lung disease (ILD) as part of its systemic manifestations. The fibrotic changes in scleroderma can lead to esophageal dysfunction and lung involvement.
- Other Likely diagnoses:
- Systemic Lupus Erythematosus (SLE): SLE can cause ILD and also has gastrointestinal manifestations, including esophageal dysmotility that might lead to hiatus hernia.
- Rheumatoid Arthritis (RA): RA can cause ILD and, less commonly, esophageal issues that might contribute to the development of a hiatus hernia.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Lymphangioleiomyomatosis (LAM): Although rare, LAM can cause ILD and has been associated with other systemic manifestations. It's crucial to consider in women of childbearing age.
- Eosinophilic Granulomatosis with Polyangiitis (Churg-Strauss Syndrome): This condition can cause asthma, ILD, and gastrointestinal symptoms, including potential esophageal involvement.
- Rare diagnoses:
- Ehlers-Danlos Syndrome: Certain types of Ehlers-Danlos syndrome can lead to gastrointestinal issues, including hiatus hernia, and might have pulmonary manifestations, though ILD is less common.
- Marfan Syndrome: While primarily known for cardiovascular and musculoskeletal manifestations, Marfan syndrome can also involve the lungs and gastrointestinal system, potentially leading to ILD and hiatus hernia, respectively.