Differential Diagnosis for Abdominal Symptoms and Vasculitis
Single Most Likely Diagnosis
- Polyarteritis Nodosa (PAN): This is a medium-vessel vasculitis that can present with abdominal symptoms such as pain, nausea, and vomiting, along with systemic symptoms like fever and weight loss. The involvement of multiple organ systems and the presence of vasculitis make PAN a strong consideration.
Other Likely Diagnoses
- Henoch-Schönlein Purpura (HSP): A small-vessel vasculitis that can cause abdominal pain, gastrointestinal bleeding, and purpura. It is more common in children but can occur in adults.
- Eosinophilic Gastroenteritis: This condition involves eosinophilic infiltration of the gastrointestinal tract and can present with abdominal symptoms, eosinophilia, and sometimes vasculitis.
- Systemic Lupus Erythematosus (SLE): A systemic autoimmune disease that can cause vasculitis, abdominal symptoms, and a wide range of other systemic symptoms.
Do Not Miss Diagnoses
- Wegener's Granulomatosis (Granulomatosis with Polyangiitis, GPA): A small-vessel vasculitis that can affect multiple organs, including the kidneys, lungs, and gastrointestinal tract. It is crucial to diagnose early due to its potential for severe organ damage.
- Microscopic Polyangiitis (MPA): Another small-vessel vasculitis that can cause renal and pulmonary involvement, along with abdominal symptoms. It is essential to consider due to its potential severity and the need for prompt treatment.
- Abdominal Aortic Aneurysm or Dissection: While not a vasculitis, these conditions can present with abdominal pain and are life-threatening if missed.
Rare Diagnoses
- Behçet's Disease: A form of vasculitis that can affect vessels of all sizes and is characterized by oral and genital ulcers, along with eye and skin lesions. Abdominal symptoms can occur due to gastrointestinal involvement.
- Kawasaki Disease: Primarily affects children and is characterized by fever, rash, and lymphadenopathy, but can also involve the gastrointestinal tract and cause vasculitis.
- Churg-Strauss Syndrome (Eosinophilic Granulomatosis with Polyangiitis, EGPA): A small-vessel vasculitis associated with asthma and eosinophilia, which can present with abdominal symptoms among its systemic manifestations.