Differential Diagnosis
- Single most likely diagnosis
- Polycystic Ovary Syndrome (PCOS): The combination of anxiety, night sweats, and increased chin hair (hirsutism) in a 31-year-old woman suggests hormonal imbalances, which are characteristic of PCOS. The presence of palpable lymph nodes could be related to a variety of factors, including stress or infection, but in the context of other symptoms, PCOS remains a strong consideration due to its association with metabolic and hormonal disturbances.
- Other Likely diagnoses
- Thyroid Disorders: Night sweats and anxiety can be symptoms of thyroid dysfunction, such as hyperthyroidism. The increased hair growth could also be related to hormonal imbalances associated with thyroid issues.
- Adrenal Disorders: Conditions like Cushing's syndrome can cause hirsutism, night sweats, and potentially anxiety due to the hormonal imbalances they induce.
- Stress or Anxiety Disorder: While anxiety is listed as a symptom, it could also be a primary condition (e.g., generalized anxiety disorder) contributing to or exacerbating other symptoms like night sweats.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Lymphoma: The presence of palpable lymph nodes, particularly if they are persistent or growing, necessitates consideration of lymphoma, a type of cancer that can present with lymphadenopathy.
- Melanoma: Although the mole was previously deemed benign, any change in color, especially if it occurs in a pattern that is not uniform, warrants re-evaluation for melanoma, a potentially deadly skin cancer.
- Pheochromocytoma: This rare tumor of the adrenal gland can cause episodic symptoms including anxiety, sweating, and potentially palpitations, although it is less likely.
- Rare diagnoses
- Congenital Adrenal Hyperplasia (CAH): A group of inherited disorders that affect the adrenal glands, leading to hormone imbalances. It could explain hirsutism and potentially other symptoms, though it's less common in adults without a previous diagnosis.
- Carney Complex: A rare genetic disorder characterized by skin and cardiac myxomas, endocrine tumors, and other features, including potentially hirsutism and skin lesions.
Each of these diagnoses requires careful consideration of the patient's full clinical picture, including further history, physical examination, and potentially diagnostic tests to determine the underlying cause of their symptoms.