Differential Diagnosis for Young Female with ANA Positive, Anti-dsDNA Positive, and Pulmonary Hypertension
- Single Most Likely Diagnosis
- Systemic Lupus Erythematosus (SLE): This diagnosis is the most likely due to the presence of a positive ANA and anti-dsDNA, which are specific markers for SLE. Pulmonary hypertension is a known complication of SLE, further supporting this diagnosis.
- Other Likely Diagnoses
- Mixed Connective Tissue Disease (MCTD): MCTD can present with a combination of features from SLE, scleroderma, and polymyositis, including positive ANA and anti-dsDNA. Pulmonary hypertension is a common feature in MCTD.
- Scleroderma (Systemic Sclerosis): While less likely than SLE due to the specific antibodies mentioned, scleroderma can cause pulmonary hypertension and may have a positive ANA. However, anti-dsDNA is less commonly associated with scleroderma.
- Do Not Miss Diagnoses
- Pulmonary Embolism: Although less likely given the autoimmune markers, pulmonary embolism can cause pulmonary hypertension and must be considered due to its high mortality rate if untreated.
- Pulmonary Vasculitis (e.g., Wegener's Granulomatosis): These conditions can cause pulmonary hypertension and may have overlapping features with autoimmune diseases, including positive ANA in some cases.
- Rare Diagnoses
- Antiphospholipid Syndrome: While this condition can cause pulmonary hypertension, it is less directly associated with anti-dsDNA positivity. However, it can coexist with SLE and should be considered, especially if there's a history of thrombotic events.
- Eosinophilic Granulomatosis with Polyangiitis (Churg-Strauss Syndrome): A rare form of vasculitis that can involve the lungs and cause pulmonary hypertension, though it is less commonly associated with the specific antibodies mentioned.