Differential Diagnosis for Eosinophilia with Decreased Kidney Function
Single Most Likely Diagnosis
- Churg-Strauss Syndrome (Eosinophilic Granulomatosis with Polyangiitis): This condition is characterized by asthma, eosinophilia, and vasculitis affecting multiple organs, including the kidneys, which can lead to decreased kidney function. The combination of eosinophilia and renal impairment makes this a highly plausible diagnosis.
Other Likely Diagnoses
- Acute Interstitial Nephritis (AIN) with Eosinophilia: AIN can be caused by medications, infections, or other factors, and it may present with eosinophilia. Decreased kidney function is a hallmark of this condition.
- Membranous Nephropathy with Eosinophilia: Although less common, some cases of membranous nephropathy can present with eosinophilia, possibly due to an allergic reaction or an underlying condition.
- Polyarteritis Nodosa (PAN): PAN is a vasculitis that can affect various organs, including the kidneys, and may present with eosinophilia, although this is less common.
Do Not Miss Diagnoses
- Goodpasture's Syndrome: Although typically associated with anti-GBM antibodies and not commonly with eosinophilia, it's crucial to consider due to its potential for rapid progression to severe kidney failure and the importance of early treatment.
- Wegener's Granulomatosis (Granulomatosis with Polyangiitis): Similar to Goodpasture's, while eosinophilia is not a hallmark, the potential for severe kidney damage and the importance of prompt treatment make it a diagnosis not to be missed.
Rare Diagnoses
- Eosinophilic Granuloma with Renal Involvement: Part of the spectrum of Langerhans cell histiocytosis, this condition can rarely affect the kidneys and present with eosinophilia.
- Hypereosinophilic Syndrome (HES) with Renal Involvement: A group of disorders characterized by persistent and marked eosinophilia, which can lead to organ damage, including the kidneys, although renal involvement is less common.
- Allergic Bronchopulmonary Aspergillosis (ABPA) with Renal Involvement: While primarily a pulmonary condition, ABPA can occasionally be associated with eosinophilia and, in rare cases, may have renal manifestations due to the underlying hypersensitivity reaction or secondary amyloidosis.