Differential Diagnosis for Eosinophilia Pleural Effusion in a Pregnant Patient with Lupus
- Single Most Likely Diagnosis
- Systemic Lupus Erythematosus (SLE) flare: This is the most likely diagnosis given the patient's history of lupus. SLE can cause pleural effusions, and eosinophilia can be seen in various autoimmune and inflammatory conditions, including lupus. The pregnancy may also be contributing to the flare.
- Other Likely Diagnoses
- Pulmonary embolism: Although less common in pregnant patients with lupus, pulmonary embolism can cause pleural effusion and eosinophilia. The hypercoagulable state of pregnancy increases the risk of thromboembolic events.
- Churg-Strauss syndrome: This is a type of vasculitis that can cause eosinophilia and pleural effusion. Although rare, it's more likely in patients with a history of autoimmune diseases like lupus.
- Lymphoma: Certain types of lymphoma, such as Hodgkin's lymphoma, can cause eosinophilia and pleural effusion. The patient's immune system is already compromised due to lupus, making them more susceptible to lymphoma.
- Do Not Miss Diagnoses
- Tuberculosis: TB can cause pleural effusion and eosinophilia, especially in immunocompromised patients like those with lupus. It's essential to consider TB due to its potential severity and the need for prompt treatment.
- Pneumonia: Bacterial or viral pneumonia can cause pleural effusion and eosinophilia. In a pregnant patient with lupus, pneumonia can quickly become severe and life-threatening.
- Rare Diagnoses
- Eosinophilic granuloma with polyangiitis (EGPA): Formerly known as Churg-Strauss syndrome, this condition is rare but can cause eosinophilia and pleural effusion. It's more likely in patients with a history of asthma or other allergic conditions.
- Histiocytosis: This is a rare group of diseases that can cause eosinophilia and pleural effusion. It's essential to consider histiocytosis in patients with unexplained eosinophilia and pleural effusion, although it's unlikely in this case.
- Parasitic infections: Certain parasitic infections, such as parasitic pneumonia, can cause eosinophilia and pleural effusion. However, these infections are rare in developed countries and would be unlikely in this patient unless she has a history of travel to endemic areas.