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What Causes Swelling On One Side Of Face Along With Swollen Feet?

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Posted on Wed, 7 Jan 2015
Question: Exactly One side of my face was swollen.then it switched to other side. also had swollen feet. it seems to travel all over body. tongue and throat.
accompanied by welts under arms welts red spots and swelling traveling all over body along with some stomach pain that comes and goes. was thought to be an allergic reaction but it did not respond to medication. on steroids now but not helping. on day 10.
woke up with totally swollen face.
doctor
Answered by Dr. Parin N. Parmar (2 hours later)
Brief Answer:
Please give more details

Detailed Answer:
Hello,

Thank you for asking at HCM.

I went through your history and would like to know more about you like:

a. How the complaints started on the first day? Was it first time in early morning? Did it start with hives? Did you have burning or itching associated? Please give more description of how the things started.

b. Do red spots respond to antihistamines or they also persist? How much itching do you have?

c. Did you have similar complaints any time before?

d. Does any particular food do you think is aggravating your symptoms?

e. Do you have any other allergies like allergic rhinitis, asthma, food allergies, etc?

f. Do you have any other medical conditions? Did you have any recent surgery? Do you have to take any particular medications frequently/regularly?

g. Did you undergo any laboratory testing? What are the results?

h. Since when do you have stomach pain? Do you have any other digestions related problem?

Above details would help me to understand your problem in a better way and thereby to make suggestions for you more specifically.

At present, I would suggest you as follows:

1. I usually treat my such patients with antihistamines and steroids (that you are already taking). I usually suggest them higher doses of antihistamines, for example double or triple of the normal dose. However, side effects are common at these doses.

Please consult your doctor before making any changes in doses.

2. I also suggest them to avoid any analgesic drugs (pain killers) as they could aggravate the condition.

Hope above suggestions will help you.

Please give me above details so that I would make more specific suggestions on follow-up.

Wish you the best of the health ahead.

Thank you & Regards,

Dr Parin N Parmar
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
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Follow up: Dr. Parin N. Parmar (7 hours later)
a. How the complaints started on the first day? Was it first time in early morning? Did it start with hives? Did you have burning or itching associated? Please give more description of how the things started.

It started with feet swelling during my work hours. it may have started in morning but I didn't notice anything to mid afternoon. Thought it was just bad shoe fit, but then 2 days later exactly half of my face swelled. You could almost see an exact line drawn down the middle of my nose/lips/etc. It started to go away within 24 hrs and then the other half of my face did the same thing. When that went down I started getting hives/rashes. Most vigorously under my arm pits but little spots all over body. While the rash was coming out, it was red and itchy. Over the last 2 weeks symptoms keep coming and going. Have since had genitals swelling to almost double the size, then nose and eyes swelling and more recently neck swelling. All interspersed with hives/rashes that keep coming and going, almost always under pits and then among various parts of body...back, butt, arms, legs. They start out as small red spots then grow to about 100x their size within an hour or two.

b. Do red spots respond to antihistamines or they also persist? How much itching do you have?
Thought that the antihistamines were helping but I think now that symptoms just runs their course (seem to dissipate with 24 hrs). I have itching while they are growing but not unbearably so.

c. Did you have similar complaints any time before? No

d. Does any particular food do you think is aggravating your symptoms? Not that I can notice.

e. Do you have any other allergies like allergic rhinitis, asthma, food allergies, etc?
I had a full food allergy panel last week and nothing came up that I'm allergic to. Didn't test for gluten (doing today & for mold) but I don't think it would present symptoms like this (??) Have not been allergic to any foods so far in my life.

f. Do you have any other medical conditions? Did you have any recent surgery? Do you have to take any particular medications frequently/regularly? No surgeries, no regular medications. Have had Constant "gut" issues, for years, that I thought might just be irritable bowel. Almost always have stomach cramping at night and jumping back and forth between diarrhea and constipation. I also tend to get Staph infections about once a year and take bacterum (sp?) medication when it arrises.

g. Did you undergo any laboratory testing? What are the results?
yes, nothing showed up.

h. Since when do you have stomach pain? Do you have any other digestions related problem? Had for years. Get heartburn often and bad gas

Above details would help me to understand your problem in a better way and thereby to make suggestions for you more specifically.

At present, I would suggest you as follows:

1. I usually treat my such patients with antihistamines and steroids (that you are already taking). I usually suggest them higher doses of antihistamines, for example double or triple of the normal dose. However, side effects are common at these doses. I have tried double and triple doses of antihistamines and doesn't seem to have any further affect.

Please consult your doctor before making any changes in doses.

2. I also suggest them to avoid any analgesic drugs (pain killers) as they could aggravate the condition. OK
doctor
Answered by Dr. Parin N. Parmar (1 hour later)
Brief Answer:
Look for parasites, h pylori, airborne allergens

Detailed Answer:
Hello,

Thank you for your follow-up. Your details are useful.

I would like to make suggestions for you as follows:

1. Since you have all symptoms for less than a month and for the first time, I would first think of "acute urticaria & angioedema".

2. There are many possible causes for the condition including viral, bacterial or parasitic infection, allergies, physical causes like pressure, sweating, cold, warmth, etc, or sometimes it may not be possible to identify a cause.

3. I usually suggest my such patients daily antihistamines for 7-14 days, usually cetirizine in morning and hydroxyzine in evening. I would also suggest you to continue steroids prescribed by you. So I would agree with your current treatment.

4. As you have repeated gut issues and heart burn symptoms, I would think of two possible causes: intestinal worms and H pylori infection. So I would suggest you tests for both of them. I usually also prescribe anti-parasitic drugs to my such patients even without stool testing as in XXXXXXX intestinal infections are very commonly seen.

5. Please avoid NSAID group of medicines (for example, ibuprofen, diclofenac, etc) while you have current symptoms, they can aggravate the symptoms.

6. I would not think of food allergy for you as there is no clear relation with food. In general, I usually suggest my such patients to avoid too spicy or too hot food.

7. Regarding allergy testing, sometimes air-borne allergens (molds, house dust mites, etc) can cause such symptoms. However, as you have significant gut symptoms, I would first think of intestinal infections or H pylori infection.

Hope above suggestions will be helpful to you.

Should you have any further query, please feel free to ask at follow-up. It will be my humble pleasure to help you with best of my knowledge and experience.

Wish you a very quick recovery and a healthy life ahead.

Thank you & Regards,

Dr Parin N Parmar
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Parin N. Parmar (4 hours later)
Thank you very much. What about HVE as a possibility?
doctor
Answered by Dr. Parin N. Parmar (1 hour later)
Brief Answer:
Would not think of HAE

Detailed Answer:
Hello,

I think you are about HAE (Hereditary Angioedema)?

HAE usually does not have accompanying urticaria. HAE only has angioedema without urticaria/hives.

As you have accompanying hives, I would not think of HAE for you.

Can you please specify what you mean by HVE?

Wish you the best of the health ahead.

Thank you & Regards,

Dr Parin N Parmar
Note: For further information on diet changes to reduce allergy symptoms or to boost your immunity, Ask here.

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
Answered by
Dr.
Dr. Parin N. Parmar

Allergist and Immunologist

Practicing since :2006

Answered : 870 Questions

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What Causes Swelling On One Side Of Face Along With Swollen Feet?

Brief Answer: Please give more details Detailed Answer: Hello, Thank you for asking at HCM. I went through your history and would like to know more about you like: a. How the complaints started on the first day? Was it first time in early morning? Did it start with hives? Did you have burning or itching associated? Please give more description of how the things started. b. Do red spots respond to antihistamines or they also persist? How much itching do you have? c. Did you have similar complaints any time before? d. Does any particular food do you think is aggravating your symptoms? e. Do you have any other allergies like allergic rhinitis, asthma, food allergies, etc? f. Do you have any other medical conditions? Did you have any recent surgery? Do you have to take any particular medications frequently/regularly? g. Did you undergo any laboratory testing? What are the results? h. Since when do you have stomach pain? Do you have any other digestions related problem? Above details would help me to understand your problem in a better way and thereby to make suggestions for you more specifically. At present, I would suggest you as follows: 1. I usually treat my such patients with antihistamines and steroids (that you are already taking). I usually suggest them higher doses of antihistamines, for example double or triple of the normal dose. However, side effects are common at these doses. Please consult your doctor before making any changes in doses. 2. I also suggest them to avoid any analgesic drugs (pain killers) as they could aggravate the condition. Hope above suggestions will help you. Please give me above details so that I would make more specific suggestions on follow-up. Wish you the best of the health ahead. Thank you & Regards, Dr Parin N Parmar