Differential Diagnosis for Eosinophilia with Toe Gangrene
- Single most likely diagnosis
- Churg-Strauss Syndrome: This is a form of vasculitis that is characterized by asthma, eosinophilia, and vasculitic symptoms, which can include gangrene. The combination of eosinophilia and toe gangrene makes this a strong consideration.
- Other Likely diagnoses
- Polyarteritis Nodosa (PAN): A systemic vasculitis that can cause eosinophilia and ischemic symptoms such as gangrene due to inflammation of medium-sized arteries.
- Buerger's Disease (Thromboangiitis Obliterans): Although not typically associated with eosinophilia, it can cause gangrene and is more common in smokers. Eosinophilia could be a secondary response to tissue damage.
- Hypereosinophilic Syndrome: A condition characterized by persistent and marked eosinophilia that can lead to end-organ damage, including vascular complications.
- Do Not Miss
- Sickle Cell Disease: While not directly associated with eosinophilia, sickle cell crisis can lead to ischemic events, including gangrene. Eosinophilia might be seen in response to chronic inflammation or infection.
- Atherosclerosis with Infection: Infection of an atherosclerotic plaque could lead to eosinophilia and, if the infection compromises blood flow, could result in gangrene.
- Embolic Events: Either from cardiac sources (e.g., atrial fibrillation) or paradoxical emboli, these could cause acute limb ischemia leading to gangrene. Eosinophilia might not be directly related but could be seen in the context of an inflammatory response.
- Rare diagnoses
- Eosinophilic Granulomatosis with Polyangiitis (EGPA): Formerly known as Churg-Strauss Syndrome, this condition is now more specifically defined within the spectrum of ANCA-associated vasculitides. It remains a consideration but is less likely than when the term was used more broadly.
- Loeffler's Syndrome: A form of pulmonary eosinophilia that could potentially have systemic manifestations, including vascular complications, though this would be uncommon.
- Tropical Pulmonary Eosinophilia: Typically associated with parasitic infections, this could potentially lead to systemic symptoms, including vascular events, in rare cases.