[36F] With body pain, swollen lymph nodes, and chest tightness

Patient Description

A 36-year-old female presents with body pain, particularly in the neck, along with swollen lymph nodes in the neck, chest tightness, and gallstones. The patient reports a CRP level of 30, indicating inflammation. The body pain began gradually over the past few days and is rated as 4 out of 10 in severity. The patient denies any recent injuries, infections, fever, chills, or cough. She experiences intermittent shortness of breath accompanying the chest tightness. There is a family history of autoimmune diseases, specifically rheumatoid arthritis and lupus, but the patient has not been diagnosed with any autoimmune conditions herself. Her medical history includes hypothyroidism diagnosed two years ago. Current medications include Wellbutrin, Viibryd, Levothyroxine, and Wegovy. The patient has an allergy to amoxicillin. No recent changes in diet or digestion have been noted, and there has been no recent travel to areas with known infections or outbreaks.

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Arora's Assessment

What might be happening

Based on the symptoms and information you've provided, here are some possible explanations for what might be happening:

  1. Infection or Inflammatory Condition: The combination of body pain, swollen lymph nodes, and elevated CRP levels suggests an inflammatory process or infection. While you haven't reported a recent infection, it's possible that a low-grade or subclinical infection could be present. Inflammatory conditions, such as autoimmune diseases, could also be a factor, especially given your family history of rheumatoid arthritis and lupus.

  2. Gallstones: Gallstones can cause abdominal pain and may sometimes lead to inflammation of the gallbladder (cholecystitis), which could contribute to your overall discomfort. However, gallstones typically do not cause neck pain or swollen lymph nodes.

  3. Thyroid Function: As you have hypothyroidism, it's important to ensure that your thyroid hormone levels are well-managed, as imbalances can contribute to fatigue, body pain, and other systemic symptoms.

  4. Chest Tightness and Shortness of Breath: These symptoms could be related to anxiety, a respiratory condition, or even cardiovascular issues. It's important to monitor these symptoms closely, especially if they worsen.

What you can do

Body Pain and Swollen Lymph Nodes:

  • Consider seeing a healthcare provider to evaluate the cause of your swollen lymph nodes and elevated CRP levels. They may recommend blood tests or imaging studies to identify any underlying infections or inflammatory conditions.
  • Over-the-counter pain relievers, such as ibuprofen or acetaminophen, may help alleviate body pain. However, consult with your doctor before taking any new medications.

Gallstones:

  • If you experience severe abdominal pain, fever, or jaundice, seek medical attention promptly, as these could be signs of gallbladder inflammation or blockage.
  • Maintain a healthy diet low in fat to help manage gallstone symptoms.

Chest Tightness and Shortness of Breath:

  • If these symptoms worsen or are accompanied by chest pain, seek medical attention immediately, as they could indicate a more serious condition.
  • Practice relaxation techniques, such as deep breathing exercises, to help manage anxiety-related symptoms.

General Health:

  • Keep track of your symptoms using the MDandMe journal to identify any patterns or triggers. This information can be valuable for your healthcare provider.
  • Ensure your thyroid medication is taken as prescribed and follow up with your doctor to monitor your thyroid levels.

What you should look out for

  • Seek immediate medical attention if you experience severe chest pain, difficulty breathing, or any signs of a severe allergic reaction.
  • Monitor for any new or worsening symptoms, such as persistent fever, unexplained weight loss, or significant changes in your health.
  • Keep an eye on your lymph nodes; if they continue to enlarge or become painful, consult your healthcare provider.

Remember, while I can provide information and suggestions, it's important to consult with a healthcare professional for a formal diagnosis and personalized treatment plan.

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5 mo ago

People Also Ask


What could cause swollen lymph nodes and elevated CRP levels without a recent infection?

Swollen lymph nodes and elevated CRP levels can indicate an inflammatory process or a low-grade infection that might not present with typical symptoms. Autoimmune conditions, given the family history, could also be a factor.


How can gallstones affect overall health, and what symptoms should prompt immediate medical attention?

Gallstones can lead to abdominal pain and potentially cause inflammation of the gallbladder. Severe abdominal pain, fever, or jaundice are symptoms that require immediate medical attention as they could indicate gallbladder inflammation or blockage.


Can hypothyroidism contribute to symptoms like body pain and fatigue?

Yes, hypothyroidism can lead to symptoms such as fatigue and body pain if thyroid hormone levels are not well-managed. It's important to regularly monitor thyroid levels and adjust medication as needed.


What should be done if experiencing chest tightness and shortness of breath?

If chest tightness and shortness of breath worsen or are accompanied by chest pain, seek medical attention immediately as these could indicate a serious condition. Relaxation techniques may help if anxiety is a contributing factor.


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