[52F] Experiencing acute onset of multiple symptoms

Patient Description

A 52-year-old female presents with acute onset of generalized itching described as a burning, crawling sensation, unrelieved by cold water, and affecting the head, neck, arms, underarms, back, and groin. She also reports abdominal pain above the belly button characterized as burning and cramping, with intermittent sensations of impending vomiting, rated up to 6 out of 10 in severity. Additionally, the patient has noticed a swollen bottom lip and a burning sensation in the tongue, both of which started concurrently with the itching. The patient experiences chills and has redness on the face, scalp, neck, chest, arms, and abdomen, but no difficulty breathing or swallowing. The patient is very thirsty and has a known allergy to sulfa drugs but is not currently on any medications. There is no history of chronic illnesses or pre-existing conditions.

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Arora's Assessment

What might be happening

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

  • Anaphylaxis: This is a severe and potentially life-threatening allergic reaction. Symptoms can include itching, hives, swelling of the lips, abdominal pain, and a feeling of warmth. It can occur within minutes to hours after exposure to an allergen.

    • Treatment typically involves immediate administration of epinephrine (adrenaline), followed by other treatments as necessary.
  • Food Allergy: This can cause symptoms similar to those of anaphylaxis, but they are usually less severe. Common symptoms include itching, hives, swelling of the lips, and abdominal pain.

    • Treatment involves avoiding the food that causes the allergy. Antihistamines can help relieve symptoms.
  • Mast Cell Activation Syndrome (MCAS): This is a condition in which the body's mast cells (a type of immune cell) are overly active, leading to a range of symptoms including itching, abdominal pain, and swelling of the lips.

    • Treatment typically involves medications to control the overactive mast cells and manage symptoms.

What you can do

Given the severity and sudden onset of your symptoms, it's crucial that you seek immediate medical attention. Please call an ambulance or go to the emergency department right away.

In the meantime, try to stay calm and sit up to help with breathing. If you have an epinephrine autoinjector (EpiPen), use it as directed.

What you should look out for

Watch for signs of worsening symptoms, such as difficulty breathing, a rapid or irregular heartbeat, or loss of consciousness. If you experience any of these symptoms, it's crucial to get to the emergency department immediately.

Remember, I'm an AI and not a doctor. This advice is based on the information you provided and is not a substitute for professional medical advice. Please seek immediate medical attention.

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People Also Ask


What are the common symptoms of anaphylaxis?

Common symptoms of anaphylaxis include itching, hives, swelling of the lips and face, abdominal pain, difficulty breathing, a rapid heartbeat, and a feeling of warmth. It is a medical emergency that requires immediate treatment with epinephrine.


How can food allergies be managed effectively?

Food allergies can be managed by avoiding the allergenic food, reading food labels carefully, and carrying antihistamines to relieve mild symptoms. In severe cases, carrying an epinephrine autoinjector is recommended.


What is Mast Cell Activation Syndrome (MCAS) and how is it treated?

Mast Cell Activation Syndrome (MCAS) is a condition where mast cells release too many chemicals, causing symptoms like itching, abdominal pain, and swelling. Treatment involves medications to stabilize mast cells and manage symptoms, such as antihistamines and mast cell stabilizers.


What should I do if I suspect I'm having a severe allergic reaction?

If you suspect a severe allergic reaction, use an epinephrine autoinjector if available, call emergency services, and seek immediate medical attention. Stay calm, sit up to aid breathing, and monitor for worsening symptoms.


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