[28F] With cervical lymphadenopathy and systemic symptoms

Patient Description

A 28-year-old female presents with localized swelling of all cervical lymph nodes, including posterior, anterior, and deep, bilaterally. The lymph nodes are generally soft and painless, with some smaller ones being harder. The patient reports a rash that appeared suddenly, intense itching, and abdominal distension with visual swelling in the upper quadrants. Bloodwork shows neutrophilia and lymphocytopenia. There is a history of chronic Epstein-Barr virus (CEBV) infection, raising concerns about potential lymphoma. The patient has experienced fluctuating lymph node size without known cause and a recent fever reaching 103°F, managed with over-the-counter medications. The rash resolved with steroid treatment. No recent infections, illnesses, weight loss, or night sweats reported. Upcoming medical evaluations include a splenic ultrasound and potential lymph node ultrasound.

Arora's Assessment

What might be happening

Based on your symptoms and history, here are some possibilities:

Lymphoma: This is a type of cancer that affects the lymphatic system. Symptoms can include swollen lymph nodes, itching, and changes in blood cell counts. Your history of chronic Epstein-Barr Virus (CEBV) can increase the risk, so it's important to follow up with your healthcare provider.
Infection or Inflammatory Condition: Infections or autoimmune conditions can cause lymph node swelling, skin rashes, and changes in blood counts. These might be viral or bacterial in nature.
Allergic Reaction or Dermatitis: The rash and itching could be due to an allergic reaction or dermatitis, which can sometimes cause lymph node swelling.

What you can do

Follow Up with Your Doctor: It's crucial to attend your upcoming appointments and discuss your symptoms and concerns. They may recommend further tests, such as imaging or a biopsy, to rule out lymphoma or other conditions.
Symptom Tracking: Use MDandMe to journal your symptoms, track any changes, and share this information with your healthcare provider. This can help in identifying patterns or triggers.
Manage Itching: Over-the-counter antihistamines or topical creams may help relieve itching. However, consult your doctor before starting any new medication.
Stay Informed: Educate yourself about your symptoms and potential conditions, but rely on your healthcare provider for diagnosis and treatment plans.

What you should look out for

New or Worsening Symptoms: If you notice new symptoms like unexplained weight loss, night sweats, or persistent fever, seek medical attention promptly.
Changes in Lymph Nodes: If the lymph nodes become hard, fixed, or significantly larger, inform your doctor.
Severe Reactions: If you experience severe itching, difficulty breathing, or other concerning symptoms, seek immediate medical care.

Remember, only a healthcare professional can provide a formal diagnosis and appropriate treatment plan.

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3 mo ago

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