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What Causes Swelling All Over Body, Joints Restriction And Difficulty In Swallowing?
Question: Respected Doctor,
My wife was suffering from whole body swelling, itching, generalized pain, puffy face, joints restriction, swallowing difficulty, jaw movement restriction for two months. Local physicians/specilists/dermatologist/
were consulted. Some anti-histamin medicines, skin ointment, anti-inflammatory medicines, vitamins could not do anything rather condition deteriorated gradually. Doctors suspected some auto-immune disease like MCTD/SLE/Scleroderma/Dermatomyositis but could not give required treatment because all auto-immune markers including ANA done three times each in different Labs had turned out negative. It was very difficult for her to bear with the conditions. In a serious condition when skin was hardened she was admitted in a Specialized Hospital. A group of doctors had examined her but could not come in any definite diagnosis. Eosonophil, ESR, Absolute Eosonophil Count and WBC were very high. They had treated her emperically by Pulse Methyl Prednisolone IV for 5 days of 1g each. Skin biopsy and muscle biopsy were done before treatment. Her condition was immediately relieved. Then discharged her with medicines to continue Oral Prednisolone Tab 40mg, CCM 1000mg, Calcirol granules once in week, Thyronorm 50mcg and Vitamins. After 1 month Tab Azoran(Azathioprine) 50mg started. Prednisolone Tab 40mg continued for 2 months and then reduced to 35mg/30mg/25mg.
During the treatment in that Hospital she felt lump in her left breast and USG was done which was normal in all respect. No medicine was given for that. Still now lump exists and also in right breast now. There is pain, tenderness and reddish skin. Today after 3 months again USG of both breasts done. Right breast is normal in all respect but in left breast (III-defined hypoechoic area at upper(9x3mm) and lateral compartment(45x11mm) found. What does it mean ?
I request you to comment on the USG report of her breasts and also about the treatment she has received at last and is being undergone. I do attache herewith the USG report for your kind perusal.
XXXX, 12-01-2015, XXXXXXX E-mail : YYYY@YYYY
My wife was suffering from whole body swelling, itching, generalized pain, puffy face, joints restriction, swallowing difficulty, jaw movement restriction for two months. Local physicians/specilists/dermatologist/
were consulted. Some anti-histamin medicines, skin ointment, anti-inflammatory medicines, vitamins could not do anything rather condition deteriorated gradually. Doctors suspected some auto-immune disease like MCTD/SLE/Scleroderma/Dermatomyositis but could not give required treatment because all auto-immune markers including ANA done three times each in different Labs had turned out negative. It was very difficult for her to bear with the conditions. In a serious condition when skin was hardened she was admitted in a Specialized Hospital. A group of doctors had examined her but could not come in any definite diagnosis. Eosonophil, ESR, Absolute Eosonophil Count and WBC were very high. They had treated her emperically by Pulse Methyl Prednisolone IV for 5 days of 1g each. Skin biopsy and muscle biopsy were done before treatment. Her condition was immediately relieved. Then discharged her with medicines to continue Oral Prednisolone Tab 40mg, CCM 1000mg, Calcirol granules once in week, Thyronorm 50mcg and Vitamins. After 1 month Tab Azoran(Azathioprine) 50mg started. Prednisolone Tab 40mg continued for 2 months and then reduced to 35mg/30mg/25mg.
During the treatment in that Hospital she felt lump in her left breast and USG was done which was normal in all respect. No medicine was given for that. Still now lump exists and also in right breast now. There is pain, tenderness and reddish skin. Today after 3 months again USG of both breasts done. Right breast is normal in all respect but in left breast (III-defined hypoechoic area at upper(9x3mm) and lateral compartment(45x11mm) found. What does it mean ?
I request you to comment on the USG report of her breasts and also about the treatment she has received at last and is being undergone. I do attache herewith the USG report for your kind perusal.
XXXX, 12-01-2015, XXXXXXX E-mail : YYYY@YYYY
Brief Answer:
FNAC and / or MRI
Detailed Answer:
Hi Madam.
Good evening once again.
Part of the questions/ information we already dealt with previously.
Seen the USG Report: By Dr Mitu XXXXXXX 12-1-15
I mentions 2 ill-defined hypoechoic area 9X3 mm upper and 45 X 11 mm lateral compartment left breast. Axillary tail is normal, Right breast normal.
Just wanted to confirm your symptoms at the moment... Is pain, tenderness and redness of the skin present ? Are these symptoms in one breast (left) or both ?
The best ways to get a diagnosis are:
-MRI of the brests if the MRI center in your area has this facility for breasts too.
-FNAC- fine needle aspiration cytology gives better accuracy if done by a good surgeon or a Pathologist, preferably under ultrasonography guidance.
-Biopsy : is the best and sure-shot diagnostic way, but I am afraid with the present condition you are going through and the medicines you are taking, one would not like to do any surgery.
So please go for MRI and / or FNAC to get a proper diagnosis to make sure what the problem is and to have treatment accordingly.
I hope this answer helps you to get the proper diagnosis and further management.
Rest of the treatment to continue as it is going on.
Please feel free to give me feedback and ask for more.
FNAC and / or MRI
Detailed Answer:
Hi Madam.
Good evening once again.
Part of the questions/ information we already dealt with previously.
Seen the USG Report: By Dr Mitu XXXXXXX 12-1-15
I mentions 2 ill-defined hypoechoic area 9X3 mm upper and 45 X 11 mm lateral compartment left breast. Axillary tail is normal, Right breast normal.
Just wanted to confirm your symptoms at the moment... Is pain, tenderness and redness of the skin present ? Are these symptoms in one breast (left) or both ?
The best ways to get a diagnosis are:
-MRI of the brests if the MRI center in your area has this facility for breasts too.
-FNAC- fine needle aspiration cytology gives better accuracy if done by a good surgeon or a Pathologist, preferably under ultrasonography guidance.
-Biopsy : is the best and sure-shot diagnostic way, but I am afraid with the present condition you are going through and the medicines you are taking, one would not like to do any surgery.
So please go for MRI and / or FNAC to get a proper diagnosis to make sure what the problem is and to have treatment accordingly.
I hope this answer helps you to get the proper diagnosis and further management.
Rest of the treatment to continue as it is going on.
Please feel free to give me feedback and ask for more.
Note: For further inquiries on surgery procedure and its risks or complications book an appointment now
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Answered by
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