Differential Diagnosis
- Single Most Likely Diagnosis
- Fibromyalgia: The patient's symptoms of chronic fatigue, widespread pain, tender points, and brain fog are consistent with fibromyalgia. The presence of a family history of fibromyalgia and other autoimmune disorders also supports this diagnosis.
- Other Likely Diagnoses
- Systemic Lupus Erythematosus (SLE): The patient's increasing ANA score, history of lupus on her father's side, and symptoms such as joint pain, skin rashes, and photosensitivity suggest SLE as a possible diagnosis.
- Narcolepsy: The patient's symptoms of excessive daytime sleepiness, sleep paralysis, and REM sleep disorder are consistent with narcolepsy, especially given her family history of the condition.
- Irritable Bowel Syndrome (IBS): The patient's complaints of loose stools, abdominal cramping, and worsening symptoms during her period suggest IBS.
- Endometriosis: The patient's severe menstrual cramps, heavy bleeding, and painful defecation during her period suggest endometriosis, especially given her history of ovarian cysts.
- Do Not Miss Diagnoses
- Multiple Sclerosis: The patient's symptoms of numbness, tingling, and decreased coordination, as well as her brain fog and emotional changes, could be indicative of multiple sclerosis.
- Sjögren's Syndrome: The patient's symptoms of dry eyes, mouth, and skin, as well as her joint pain and fatigue, could be indicative of Sjögren's syndrome.
- Thyroid Disorder: The patient's symptoms of fatigue, weight changes, and heat intolerance could be indicative of a thyroid disorder, such as hypothyroidism or hyperthyroidism.
- Rare Diagnoses
- Ehlers-Danlos Syndrome: The patient's symptoms of easy bruising, joint hypermobility, and skin hyperextensibility could be indicative of Ehlers-Danlos syndrome.
- Mast Cell Activation Disorder: The patient's symptoms of flushing, hives, and gastrointestinal symptoms could be indicative of mast cell activation disorder.
- Alpha-1 Antitrypsin Deficiency: The patient's family history of alpha-1 antitrypsin deficiency and her symptoms of lung and liver disease could suggest this rare genetic disorder.