The Clinical Problem Solvers Episode 434: Schema Episode – Eosinophilia
Dec 11, 2025
A captivating case of eosinophilia unfolds as the hosts discuss a 50-year-old woman presenting with rapid weight gain and edema. They explore various organ-based causes, analyzing low blood pressure's significance. The narrative dives into lab findings, highlighting marked eosinophilia and hypoalbuminemia. Discussion around possible GI causes, medication history, and a critical bone marrow biopsy reveals key insights. The diagnosis of a checkpoint inhibitor-associated reaction leads to a successful treatment response, turning a diagnostic puzzle into a medical victory.
AI Snips
Chapters
Transcript
Episode notes
Three-Organ Edema Framework
- When evaluating edema, prioritize heart, liver, and kidney as the main causes and clarify distribution and severity.
- Use history, orthopnea, JVD, and meds to quickly narrow which organ system to investigate first.
Blood Pressure As A Diagnostic Clue
- A low ambulatory blood pressure in edema steers away from classic nephrotic causes and may point to cirrhosis or cardiogenic shock.
- Use blood pressure patterns to differentiate kidney-driven hypertension from low-pressure states like cirrhosis or advanced HF.
Act Early For Possible Shock
- In suspected early shock, check bedside ultrasound, JVP, BNP, and extremity perfusion early to detect cardiogenic causes.
- Watch for narrow pulse pressure, cool extremities, or altered mentation as early shock signs.
