What Causes Puffy Face?
Needs a detailed clinical correlation
Detailed Answer:
Thank you for asking
Puffy face with clear and normal thyroid, no hypercortisolism, all labs clear needs a little more digging.
Here are some possibilities.
Renal functions derangement can cause that but that would have been g en era listed puffiness including edema feet etc.bit still a possibility as you had a history of renal stones.
Next possibility is hypertension uncontrolled. Puffy face is a diagnostic entity of hypertension and unless high blood pressure gets controlled it stays that way and takes a little time to come back to normal physiology.
It might be a possibility that you have a thyroid infection like hashimoto thyroiditis as it's classic for puffiness of face and thyroid functions show normal at the start. Antibodies assay will confirm.
Get a complete liver function panel as deranged albumin levels and reversed albumin globulin ratios and nd decreased total proteins irrespective of the etiology can also cause that.
Isolated angioedema of the face secondary to some vascular in infection and good pastures syndrome may also cause that. Vascular profile assessment and ruling out any infection and clearing the lymphatic pathway wouldgive some clue.
Last but not the least ophthalmologist consult for ruling out any eyelid cause for facial puffiness needs to be ruled out too.
Nut shell needs management and a little work up. Meanwhile reduce salt intake to less than 2 gm per day . compliance with the hypertensive meds is advised. Get complete Renal functions assessment.repeat thyroid functions and add some antibody titre for hashimoto to it. Seek your doctor and let them connect the dots for you.hang in there. It might take some time till confirming the cause.
I hope it helps. Take good care of yourself and don't forget to close the discussion please.
May the odds be ever in your favour.
Regards XXXXXXX
Yes sinus infections may cause that except,.......
Detailed Answer:
Thank you for getting back to me
Sinus infections can not cause the puffiness unless severe abscess which is least likely in your case. Rest bad taste post nasal dripping leading to cough is a hallmark if a sinus infection. Though pressure and painful face is presentation of sinus infections but that involves cheeks bones too and is mostly unilateral. Plus that does not stay for more than 14 days puffiness is still least likely.
Nut shell get assessed for the previous etiologies we suspected and also seek an otorhinolarynfologist for these sinus infections and let them take care of it.
I hope it helps. Take good care of yourself and don't forget to close the discussion please.
Regards XXXXXXX