Differential Diagnosis for Left Upper Quadrant Abdomal Pain with Vision Changes and Lung Fibrosis
Single Most Likely Diagnosis
- Sarcoidosis: This condition is a systemic granulomatous disease that can affect multiple organs, including the lungs (causing fibrosis), eyes (leading to vision changes), and abdomen (potentially causing left upper quadrant pain due to spleen involvement). Its multi-systemic nature makes it a strong candidate given the combination of symptoms.
Other Likely Diagnoses
- Systemic Lupus Erythematosus (SLE): SLE is an autoimmune disease that can affect various parts of the body, including the lungs, eyes, and abdomen. It could explain the lung fibrosis, vision changes (due to ocular manifestations), and abdominal pain (possibly from peritoneal or spleen involvement).
- Rheumatoid Arthritis (RA) with Felty's Syndrome: While RA primarily affects the joints, Felty's syndrome (a complication of long-standing RA) involves the spleen and can cause abdominal pain. RA can also be associated with lung fibrosis and, less commonly, eye symptoms that could lead to vision changes.
- Sjögren's Syndrome: This autoimmune disorder primarily affects the glands that produce tears and saliva but can also involve other organs. It might cause lung fibrosis, vision changes (due to dry eyes or other ocular manifestations), and potentially abdominal pain if there's significant systemic involvement.
Do Not Miss Diagnoses
- Lymphoma: Both Hodgkin and non-Hodgkin lymphoma can present with systemic symptoms, including abdominal pain (from spleen or lymph node involvement), lung involvement (which could lead to fibrosis), and vision changes (if there's central nervous system or ocular involvement). Missing this diagnosis could be fatal due to the aggressive nature of some lymphomas.
- Tuberculosis (TB): TB can affect the lungs, causing fibrosis, and has extrapulmonary manifestations, including abdominal (splenic) involvement and eye symptoms. TB is a critical diagnosis not to miss due to its treatability and potential for severe outcomes if left untreated.
Rare Diagnoses
- Histoplasmosis: A fungal infection that can cause lung fibrosis and, in its disseminated form, affect other organs, including the eyes and spleen, potentially leading to the described symptoms.
- Eosinophilic Granulomatosis with Polyangiitis (Churg-Strauss Syndrome): A rare autoimmune condition characterized by asthma, eosinophilia, and vasculitis that can affect multiple organs, including the lungs, eyes, and abdomen, leading to the symptoms described.
- Erdheim-Chester Disease: A rare form of histiocytosis that can involve multiple systems, including the lungs (causing fibrosis), eyes, and potentially the abdomen, though it's less likely to present with the exact combination of symptoms described.