Differential Diagnosis
- Single most likely diagnosis
- Systemic Lupus Erythematosus (SLE): This diagnosis is likely due to the presence of a positive ANA test, which is a common indicator of autoimmune disorders like SLE. The slightly elevated PTT can be seen in SLE due to the presence of lupus anticoagulant, and retinal bleeding can occur due to the vasculitis associated with SLE.
- Other Likely diagnoses
- Antiphospholipid Syndrome (APS): This condition is characterized by the presence of antiphospholipid antibodies, which can cause an elevated PTT. The positive ANA test can also be seen in APS, and retinal bleeding can occur due to the thrombotic events associated with APS.
- Rheumatoid Arthritis (RA): Although less likely than SLE, RA can also cause a positive ANA test and vasculitis, leading to retinal bleeding. The elevated PTT can be seen in RA due to the inflammation and coagulation abnormalities associated with the disease.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Catastrophic Antiphospholipid Syndrome (CAPS): This is a rare but life-threatening condition that can cause widespread thrombosis, including retinal bleeding. Although less likely, CAPS can present with an elevated PTT and positive ANA test, making it a "do not miss" diagnosis.
- Sickle Cell Disease: This condition can cause retinal bleeding due to the sickling of red blood cells, and an elevated PTT can be seen due to the chronic hemolysis and coagulation abnormalities associated with the disease. Although less likely, sickle cell disease can be deadly if missed, especially in patients with a history of hemoglobinopathy.
- Rare diagnoses
- Relapsing Polychondritis: This is a rare autoimmune disorder that can cause vasculitis and retinal bleeding. Although less likely, relapsing polychondritis can present with an elevated PTT and positive ANA test, making it a rare but possible diagnosis.
- Susac Syndrome: This is a rare condition that can cause retinal bleeding and vasculitis, and an elevated PTT can be seen due to the coagulation abnormalities associated with the disease. Although very rare, Susac syndrome can be deadly if missed, making it a rare but important diagnosis to consider.