[18F] With multiple systemic symptoms and blood count abnormalities

Patient Description

An 18-year-old female presents with a range of symptoms including moderate dizziness exacerbated by walking and standing, relieved by lying down. The dizziness began suddenly. She reports daily vomiting for a month and a half, leading to a 20-pound weight loss. Other symptoms include bone pain in the legs, hips, and arms, stomach pain, nausea, vertigo, high white blood cell count, low red blood cell count, low platelet count, low hemoglobin and hematocrit, fevers up to 103°F, itching, red bumps on the body, a lump on the leg, slightly enlarged spleen, chest pain, and fatigue. She also notes unusual bruising or bleeding and experiences night sweats or chills. Her medical history includes polycystic ovary syndrome (PCOS) diagnosed at age 15 and asthma diagnosed at age 3. Current medications are hydroxyzine 25mg, sertraline 50mg, lamotrigine 150mg, lurasidone 20mg, and metformin 2000mg, taken daily, along with weekly iron infusions for three weeks. No known allergies, no family history of blood disorders or autoimmune diseases, and no recent exposure to toxins or travel.

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Arora's Assessment

What might be happening

Your symptoms could be related to several conditions, and it's important to consult a healthcare professional for a precise diagnosis. Here are some possibilities:

  • Hematological Disorders: The combination of high white blood cell count, low red blood cell count, low platelets, and low hemoglobin could suggest a blood disorder, such as leukemia or another bone marrow condition. These can cause symptoms like fatigue, bruising, fever, and weight loss.

  • Infections or Inflammatory Conditions: The fever, enlarged spleen, and high white blood cell count might indicate an infection or inflammatory condition.

  • Nutritional Deficiencies: Your symptoms, including dizziness, fatigue, and weight loss, could also be related to nutritional deficiencies, especially given your recent vomiting and iron infusions.

  • Autoimmune Disorders: Some autoimmune conditions can cause a wide range of symptoms, including joint pain, skin changes, and blood count abnormalities.

What you can do

Dizziness and Vomiting:

  • Stay hydrated and try to eat small, bland meals.
  • Rest and avoid sudden movements to help manage dizziness.
  • Keep a record of your symptoms using MDandMe to track any changes.

Bruising and Bleeding:

  • Avoid activities that could lead to injury.
  • Monitor for any new or worsening bruising and report it to your doctor.

Fever and Fatigue:

  • Rest as much as possible and maintain a balanced diet.
  • Monitor your temperature and seek medical attention if it remains high.

Weight Loss:

  • Try to maintain a balanced diet and consult a nutritionist if needed.

What you should look out for

Seek medical attention if you experience:

  • Severe or persistent chest pain.
  • Difficulty breathing or shortness of breath.
  • Sudden or severe headaches.
  • Any new or worsening symptoms.

Remember, it's crucial to follow up with a healthcare provider to get a comprehensive evaluation and appropriate treatment.

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2 mo ago

People Also Ask

What could cause a high white blood cell count along with low red blood cell and platelet counts?

A high white blood cell count with low red blood cell and platelet counts can indicate a hematological disorder such as leukemia or another bone marrow condition. It may also suggest an infection or an inflammatory condition.

How can dizziness that worsens with standing and walking be managed?

To manage dizziness that worsens with standing and walking, it's important to stay hydrated, rest, and avoid sudden movements. Lying down can help relieve symptoms. Keeping a symptom diary can also be useful for tracking changes.

What are the potential causes of sudden weight loss and vomiting over an extended period?

Sudden weight loss and vomiting over an extended period can be caused by nutritional deficiencies, gastrointestinal disorders, infections, or more serious conditions like cancer. It's important to consult a healthcare provider for a thorough evaluation.

What might be the reason for experiencing night sweats and chills?

Night sweats and chills can be symptoms of infections, autoimmune disorders, or other systemic conditions. They may also be related to hormonal changes or certain medications. A healthcare provider can help determine the underlying cause.

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