[35F] With multiple systemic symptoms including fatigue and kidney pain

Patient Description

A 35-year-old female reports extreme fatigue, sleeping nearly 20 hours daily, and persistent kidney pain for about a year. The pain occurs daily, intensifying once or twice a day for about an hour, and has worsened over time. Increased urination frequency and occasional nausea or fullness accompany the pain. Swelling in the ankles, feet, and calves has been present off and on for a year, described as firm and painful, exacerbated by walking. Random fevers occur once or twice a month, with temperatures ranging from 100 to 103 degrees. Shortness of breath has been present for two months, with episodes rated at a severity of 6 out of 10. Additional symptoms include swollen lymph nodes, headaches/migraines, blister-like rashes, difficulty swallowing, hiccups after eating, abnormal vaginal bleeding, nipple discharge, sharp breast pain, fluctuating heart rate (tachycardia during the day and bradycardia at night), memory issues, extreme hair loss, loss of smell, mouth sores, and lumps under the skin. There is a family history of autoimmune diseases, kidney disease, and heart conditions. The patient has not been evaluated for autoimmune disorders or kidney disease and is not currently taking any medications.

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Arora's Assessment

What might be happening

Your symptoms suggest a complex situation that may involve multiple underlying issues. Here are some possibilities:

  1. Autoimmune Disorders: Given your family history and symptoms like fatigue, rashes, swollen lymph nodes, and joint pain, an autoimmune condition such as lupus or rheumatoid arthritis could be considered. These conditions can cause widespread inflammation and affect multiple organs.

  2. Kidney Issues: The kidney pain, swelling, and changes in urination could indicate a kidney condition, such as chronic kidney disease or an autoimmune-related kidney issue. Testing like blood work and imaging can help assess kidney function.

  3. Heart or Circulatory Problems: Swelling in your legs, shortness of breath, and fluctuating heart rates might suggest heart-related issues. Conditions like heart failure or arrhythmias could be considered.

  4. Infections or Inflammatory Conditions: Recurrent fevers and swollen lymph nodes could indicate chronic infections or inflammatory conditions.

What you can do

Fatigue and Sleep Issues:

  • Prioritize rest and avoid overexertion.
  • Keep a sleep diary using MDandMe to track patterns and share with your doctor.

Kidney Pain and Swelling:

  • Elevate your legs when resting to reduce swelling.
  • Stay hydrated, but avoid excessive salt intake.
  • Seek medical evaluation for kidney function tests.

Breathing Difficulties:

  • Monitor your breathing and note any triggers.
  • Avoid allergens or irritants that may worsen symptoms.
  • Seek immediate medical attention if breathing becomes severely difficult.

General Health:

  • Schedule a comprehensive evaluation with your healthcare provider.
  • Consider seeing a specialist, such as a rheumatologist or nephrologist, for further assessment.
  • Use MDandMe to journal symptoms and track changes over time.

What you should look out for

Seek medical care promptly if you experience:

  • Severe or worsening shortness of breath.
  • High fever or persistent fever.
  • Significant changes in urination or swelling.
  • Chest pain or palpitations.

Remember, this information is not a substitute for professional medical advice. Please consult a healthcare provider for a formal diagnosis and treatment plan.

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2 mo ago

People Also Ask

What could be causing extreme fatigue and excessive sleep in a 35-year-old female?

Extreme fatigue and excessive sleep could be due to several factors, including autoimmune disorders like lupus, chronic infections, or thyroid issues. It's important to consult a healthcare provider for a thorough evaluation.

What are the potential causes of persistent kidney pain and increased urination frequency?

Persistent kidney pain and increased urination frequency could indicate a kidney condition such as chronic kidney disease or an autoimmune-related kidney issue. It's crucial to undergo tests like blood work and imaging to assess kidney function.

How can swelling in the ankles, feet, and calves be related to heart or kidney issues?

Swelling in the ankles, feet, and calves can be related to heart issues like heart failure, where the heart is unable to pump blood effectively, or kidney problems that affect fluid balance. Medical evaluation is necessary to determine the underlying cause.

What might be the reason for fluctuating heart rates and shortness of breath?

Fluctuating heart rates and shortness of breath could be due to arrhythmias or heart-related issues. These symptoms warrant a comprehensive cardiovascular assessment to rule out conditions like heart failure or other circulatory problems.

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