Differential Diagnosis
The patient's complex presentation of symptoms requires a comprehensive differential diagnosis. The following categories outline potential diagnoses:
- Single most likely diagnosis
- Systemic Lupus Erythematosus (SLE): This autoimmune disease can cause a wide range of symptoms, including joint inflammation, fever, skin rashes, and neurological issues. The combination of inflammation in the neck and right hand, nocturnal low-grade fevers, pruritus, and history of a seizure makes SLE a strong consideration.
- Other Likely diagnoses
- Rheumatoid Arthritis (RA): RA can cause joint inflammation, fever, and skin symptoms, which align with some of the patient's symptoms.
- Thyroid Disorder: Hyperthyroidism can cause rapid heart rate, diarrhea, and abdominal pain, while hypothyroidism can lead to short stature, bloating, and skin issues.
- Inflammatory Bowel Disease (IBD): IBD can cause abdominal pain, diarrhea, and bloating, which are present in the patient's symptomatology.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Neurosyphilis: This condition can cause a wide range of neurological symptoms, including seizures, motor weakness, and personality changes. Although less common, it is essential to consider due to its potential severity.
- Lymphoma: This type of cancer can cause fever, night sweats, and weight loss, which may be related to the patient's nocturnal low-grade fevers and bloating.
- Multiple Sclerosis (MS): MS can cause neurological symptoms, including motor weakness, seizures, and vision problems. Although the patient's symptoms do not perfectly align with MS, it is crucial to consider due to its potential impact on quality of life.
- Rare diagnoses
- Ehlers-Danlos Syndrome: This genetic disorder can cause joint hypermobility, skin issues, and gastrointestinal symptoms, which may be related to the patient's bloating, diarrhea, and abdominal pain.
- Mitochondrial Myopathies: These disorders can cause muscle weakness, seizures, and gastrointestinal issues, which may be connected to the patient's motor weakness after sex and abdominal symptoms.
- Whipple's Disease: This rare bacterial infection can cause diarrhea, abdominal pain, and joint inflammation, which align with some of the patient's symptoms.