Differential Diagnosis for Hepatic Infarction plus Eosinophilia
Single Most Likely Diagnosis
- Polyarteritis Nodosa (PAN): This is a medium vessel vasculitis that can cause hepatic infarction due to the involvement of the hepatic arteries. Eosinophilia can be present, especially in the early stages of the disease, making it a strong candidate for the combination of symptoms described.
Other Likely Diagnoses
- Churg-Strauss Syndrome: A form of vasculitis characterized by asthma, eosinophilia, and vasculitis affecting multiple organ systems, including the liver. Hepatic infarction can occur due to the vasculitic process.
- Parasitic Infections: Certain parasitic infections, such as those caused by Ascaris or Toxocara, can lead to eosinophilia. While less common, severe infections could potentially cause hepatic infarction through mechanisms like vascular obstruction or severe inflammatory response.
- Hypereosinophilic Syndrome (HES): Although primarily known for its effects on the heart and lungs, HES can lead to eosinophilic infiltration of various organs, including the liver, potentially causing infarction through vascular occlusion or thrombosis.
Do Not Miss Diagnoses
- Acute Hepatic Artery Thrombosis: While not typically associated with eosinophilia, this condition can cause hepatic infarction. The presence of eosinophilia might be coincidental or related to another underlying condition, but missing a diagnosis of hepatic artery thrombosis could be catastrophic.
- Budd-Chiari Syndrome: Caused by thrombosis of the hepatic veins, this condition can lead to liver infarction. Eosinophilia is not a typical finding but could be present in certain cases, especially if there's an underlying myeloproliferative disorder.
Rare Diagnoses
- Eosinophilic Granulomatosis with Polyangiitis (EGPA) with Hepatic Involvement: Formerly known as Churg-Strauss syndrome, EGPA is a rare form of vasculitis that can affect the liver and cause eosinophilia. The hepatic involvement can lead to infarction in severe cases.
- Lymphoma with Eosinophilia: Certain types of lymphoma can cause eosinophilia, and if the lymphoma involves the liver, it could potentially lead to hepatic infarction, although this would be an uncommon presentation.
- Idiopathic Hypereosinophilic Syndrome with Hepatic Involvement: A rare condition characterized by persistent eosinophilia without a known cause, which can lead to organ damage, including the liver, potentially resulting in infarction.