[46F] With persistent abdominal swelling and autoimmune skin conditions

Patient Description

A 46-year-old female presents with a swollen abdomen that has been persistent for over three days. The swelling is described as tight, hard, and consistent, with no associated weight changes, discoloration, or alleviating factors. The patient has a medical history of high blood pressure, spindle cell sarcoma, rheumatoid arthritis, osteoarthritis, and obesity. She has been taking Dupixent once a week for nearly three years to manage autoimmune skin conditions, lichen planus and bullous pemphigoid, which cause itchy rashes and painful blisters. The patient has not traveled recently, does not leave her house often, and the onset of her skin conditions coincided with receiving a vaccine. She has allergies to penicillin and bactrim. No new chest pain, palpitations, or yellowing of the skin or eyes have been reported.

Arora's Assessment

What might be happening

Based on the information you've provided, here are some possibilities:

Ascites: This is a condition where fluid builds up in the abdomen, causing swelling and discomfort. It can be caused by a variety of conditions, including liver disease, heart failure, and cancer. Given your history of spindle cell sarcoma, this could be a possibility.
- Diagnostic tests for ascites often include imaging studies like an ultrasound or CT scan, and may also involve a procedure to remove and analyze a sample of the fluid (paracentesis).
- Treatment typically involves addressing the underlying cause, and may also include procedures to remove the excess fluid.
Edema: This is a condition characterized by an excess of watery fluid collecting in the cavities or tissues of the body. It can be caused by a variety of conditions, including heart, liver or kidney disease, and certain medications. Given your history of high blood pressure, this could be a possibility.
- Diagnostic tests for edema often include blood tests, urine tests, liver function tests, kidney function tests, and imaging studies.
- Treatment typically involves addressing the underlying cause and may include medication to help your body expel the excess fluid (diuretics).

Please note that these are possibilities based on the information you've provided, and not a definitive diagnosis. It's important to consult with a healthcare professional who can evaluate your symptoms in person and order the appropriate tests.

What you can do

While waiting for your appointment with a healthcare professional, here are some things you can do:

Try to limit your salt intake. Salt can cause your body to retain more fluid.
Elevate your legs when you're lying down. This can help reduce swelling in your legs.
Monitor your symptoms. If they get worse or if you develop new symptoms, seek medical attention immediately.

What you should look out for

Seek immediate medical attention if you experience any of the following:

Difficulty breathing or shortness of breath that's getting worse
Chest pain
Dizziness or fainting
Confusion or changes in consciousness
Blood in your stool or black, tarry stools

Remember, while I strive to provide accurate information, I'm not a doctor and this advice should not replace a consultation with a healthcare professional.

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11 mo ago

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