20th February 2025

A 54-year-old man with a background of poorly controlled asthma presents with worsening asthma symptoms, rhinorrhea, a low-grade fever and weight loss over the past few weeks.

A 54-year-old man with a background of poorly controlled asthma presents with worsening asthma symptoms, rhinorrhea, a low-grade fever and weight loss over the past few weeks. He has had a recent course of steroids with the GP, which only transiently improved his symptoms.

His WCC is 14 x 10⁹/L (normal: 4-11 x 10⁹/L) with neutrophils of 7.5 x 10⁹/L (normal: 2-7 x 10⁹/L) and eosinophils of 6.3 x 10⁹/L (normal: 0.1-0.4 x 109/L). His creatinine is 230 micromol/L (baseline creatinine 3 years ago was 69 micromol/L).

What is the most likely diagnosis?

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