What Can Cause Profuse Sweating?

A. Hyperthyroidism

B. Cushing syndrome

C. Adrenal insufficiency

ANSWERS TO CASE 2–1

Summary: A 20-year-old woman presents with a 10-day history of weakness, dizziness, and mild tinnitus. On examination, she is alert and oriented to person, place, time; has diffusely tender lymph nodes in the cervical area; is afebrile with normal mentation but mildly hypertensive with an initial blood pressure of 130/80 mm Hg despite diuretic therapy for dehydration. The remainder of her physical examination is remarkable only for diminished deep tendon reflexes on palpation over the thoracic spine at L2 through L4 levels due to swelling that extends into these areas from multiple myeloma or leukemia (since confirmed). Her findings are suggestive of underlying pleural effusion causing retraction artifact along the rib cage which also explains both hypertriglyceridemia and hyponatremia since fluid accumulation affects postural hydrostatic forces resulting in elevated intrathoracic pressures as well as neurologic deficits related to peripheral edema leading to decreased muscle strength (decreased strength on passive flexion test) associated with paresthesias down nerve roots T8 through T12 on both sides (Humphrey’s sign). MRI scan confirms leukemic infiltration around bilateral lung lobes extending into left upper lobe posterior mediastinum

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