Differential Diagnosis for Ascending Paresthesia and Marked Eosinophilia in an 18-Year-Old
Single Most Likely Diagnosis
- Loeffler's Syndrome: This is a type of eosinophilic pneumonia that can present with marked eosinophilia and neurological symptoms due to hypereosinophilia syndrome, which can cause ascending paresthesia. The condition is often associated with parasitic infections or can be idiopathic.
Other Likely Diagnoses
- Churg-Strauss Syndrome: A form of vasculitis that is characterized by asthma, eosinophilia, and vasculitic symptoms, which can include neurological manifestations such as paresthesia. The marked eosinophilia and potential for neurological involvement make it a plausible diagnosis.
- Parasitic Infections (e.g., Toxocariasis, Hookworm): Certain parasitic infections can cause marked eosinophilia and, in rare cases, neurological symptoms if the parasites infect the nervous system.
- Hypereosinophilic Syndrome (HES): A condition characterized by persistent and marked eosinophilia that can lead to organ damage, including neurological symptoms like ascending paresthesia due to eosinophilic infiltration.
Do Not Miss Diagnoses
- Neurocysticercosis: Caused by the pork tapeworm (Taenia solium), this condition can lead to neurological symptoms, including paresthesia, and eosinophilia. It's crucial to consider this diagnosis due to its potential severity and the need for specific treatment.
- Guillain-Barré Syndrome with Eosinophilia: Although rare, Guillain-Barré Syndrome can present with ascending paresthesia, and in some cases, it may be associated with eosinophilia, making it a critical diagnosis not to miss.
Rare Diagnoses
- Eosinophilic Granuloma with Polyangiitis (EGPA): Formerly known as Churg-Strauss syndrome, this condition is rare and involves asthma, eosinophilia, and vasculitis. It can present with a wide range of symptoms, including neurological manifestations.
- Tropical Eosinophilia: A condition seen in tropical regions, characterized by marked eosinophilia and respiratory symptoms, but can occasionally present with neurological symptoms due to the underlying cause, such as filariasis.
- Eosinophilic Meningitis: Caused by parasitic infections (e.g., Angiostrongylus cantonensis), this condition can lead to marked eosinophilia and neurological symptoms, including paresthesia, due to the involvement of the meninges.