Episodes of face flushing, hands swelling and weakness?20 year old male presents with episodes of facial flushing, hand swelling, diaphoresis, weakness, confusion, and agitation increasing in freq x several mo. The episodes occur 3-4 x per week and have no releaving factors. Seems to be worsened by change in temperature ie hot shower There is no associated anxiety, and blood pressure checked during an episode is normal. Past medical history is significant for GERD, obesity(bmi 40.5), asthma. Meds include prilosec OTC and claritin d. Allergies are sulfa and seasonal. No alcohol, tobacco or illicit drugs. Occupation is noncontributory. Family history sig for allergies, cad, and men1 syndrome (maternal grandfather and uncles).
Ddx and explanation anyone?
-Waytootiny
Loose some weight and get some exercise and breathe! I'm no doctor but from the report it sounds circulatory and a 20 yro male should be at 25 BMI or less. I'd start there.
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This sounds like a combination of things that don't relate . Facial flushing can occur for many reasons. Obviously there is some edema but the blood pressure throws me off. Water can cause body temperature fluctuation regardless. Did he run to wear himself out of breath causing the weakness? That too can cause slight confusion and disorientation.. Is he in a workout routine 3-4 times per week and these syptoms appear afterwards? Odd!
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