Differential Diagnosis for Acute Neutrophilia with Urticaria and Proteinuria
Single Most Likely Diagnosis
- Acute Post-Streptococcal Glomerulonephritis (APSGN): This condition often follows a streptococcal infection and can present with acute nephritic syndrome, which includes proteinuria. The urticaria could be related to an allergic reaction or an immune complex deposition disease, and neutrophilia can occur in response to the infection.
Other Likely Diagnoses
- Systemic Lupus Erythematosus (SLE): SLE can cause a wide range of symptoms including urticaria, proteinuria due to lupus nephritis, and neutrophilia as part of an inflammatory response. It's an autoimmune disease that can affect multiple systems.
- Vasculitis (e.g., Henoch-Schönlein Purpura, Granulomatosis with Polyangiitis): These conditions involve inflammation of blood vessels and can present with urticaria, proteinuria, and an elevated neutrophil count due to the inflammatory process.
- Infections (e.g., Pneumonia, Sepsis): Certain infections can cause neutrophilia as part of the body's response. If the infection is severe or involves specific pathogens, it could also lead to urticaria and proteinuria through various mechanisms, including immune complex deposition or direct renal injury.
Do Not Miss Diagnoses
- Wegener's Granulomatosis (now known as Granulomatosis with Polyangiitis): This is a form of vasculitis that can affect the kidneys, lungs, and other organs. It's crucial to diagnose early because it can be life-threatening if not treated promptly.
- Goodpasture Syndrome: An autoimmune disease that affects the lungs and kidneys, characterized by the presence of anti-GBM antibodies. It can present with renal failure (including proteinuria) and pulmonary hemorrhage, making it critical to diagnose and treat early.
Rare Diagnoses
- Leukocytoclastic Vasculitis: A condition characterized by inflammation of small blood vessels, which can lead to skin lesions (potentially resembling urticaria), renal involvement (proteinuria), and an elevated white blood cell count.
- Hypocomplementemic Urticarial Vasculitis Syndrome: A rare autoimmune disorder that presents with urticaria, low complement levels, and can involve renal manifestations such as proteinuria. Neutrophilia might occur as part of the inflammatory response.