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Suggest Treatment For Swollen Eyes And Severe Lower Back Pain
Question: Hello,
I am a 22 year old white European female and a professional nurse. I am sexually active with one stable partner. For the last two months I have been experiencing a lot of swelling in the eyes (every day). I’ve been feeling very tired, a little confused, and my skin is whiter than usual. I’ve also had some unusual pain in the lower back which I had not had before.
My mother has suffered from severe systemic lupus, rheumatoid arthritis, sjorgen’s syndrome and heart dysfunction since the age of 30. She is now 46 and in a very bad state.
Since August I have been taking Zoloft (Setraline) 100mg daily to help with obsessive compulsive disorder (cleaning hands). Since an early age (4 years) I have been allergic to mould and medicated every year with levocetirizine for several months daily. I had soggy eyes in the past as a symptom of allergy, however, taking anti-histamine medication now has no effect.
Currently I have had a regular check-up done at hospital and almost everything is within norm, however, I have a raised erythrocyte, leukocyte and epithelial count in urine (this test was done in a hospital laboratory, the urine was the first in the moring). I had another test done today in the afternoon with my general practitioner, who used a machine instead of sending the sample to the lab and the test didn’t show raised levels of anything (the urine wasn’t the first in the morning though).
Apart from these I don’t have any symptoms - no pain during urination. I’m not aware of any other physical symptoms.
I was wondering if you could recommend the best course of action given my symptoms and laboratory tests. I’m not sure whether visiting a nephrologist is warranted, however, I don’t want to neglect anything.
Thank you.
All the best,
XXXX
I am a 22 year old white European female and a professional nurse. I am sexually active with one stable partner. For the last two months I have been experiencing a lot of swelling in the eyes (every day). I’ve been feeling very tired, a little confused, and my skin is whiter than usual. I’ve also had some unusual pain in the lower back which I had not had before.
My mother has suffered from severe systemic lupus, rheumatoid arthritis, sjorgen’s syndrome and heart dysfunction since the age of 30. She is now 46 and in a very bad state.
Since August I have been taking Zoloft (Setraline) 100mg daily to help with obsessive compulsive disorder (cleaning hands). Since an early age (4 years) I have been allergic to mould and medicated every year with levocetirizine for several months daily. I had soggy eyes in the past as a symptom of allergy, however, taking anti-histamine medication now has no effect.
Currently I have had a regular check-up done at hospital and almost everything is within norm, however, I have a raised erythrocyte, leukocyte and epithelial count in urine (this test was done in a hospital laboratory, the urine was the first in the moring). I had another test done today in the afternoon with my general practitioner, who used a machine instead of sending the sample to the lab and the test didn’t show raised levels of anything (the urine wasn’t the first in the morning though).
Apart from these I don’t have any symptoms - no pain during urination. I’m not aware of any other physical symptoms.
I was wondering if you could recommend the best course of action given my symptoms and laboratory tests. I’m not sure whether visiting a nephrologist is warranted, however, I don’t want to neglect anything.
Thank you.
All the best,
XXXX
Brief Answer:
As discussed in details below.
Detailed Answer:
Hi.
Thanks for your query and an elucidate history:
To recapitulate: Female/22 - professional Nurse - stable partner - swelling in the eyes - 2 months - tired, confused and whiter skin than before - lower back ache - noted history about Mother - Zoloft 100 since Aug - allergic to molds since the age of 4 and takes Levocetirizine - also helped for soggy eye in past - raised erythrocyte, leukocyte and epithelial count in urine tested in Lab - but normal when done at GP - wants best course of action - not sure whether to visit a Nephrologist ...
As per the history you have provide, this looks to be a combination of many reasons as follows:
The swollen eyes can be due to an allergy as you have mentioned or can be due to effects of Sertraline and/or Levocetirizine. For knowing further you need to have additional investigations.
Tiredness, feeling confused and whiter skin can be secondary to the primary problem.
Lower back ache at your age is usually due to wrong postures, muscular spasms and so on.
I would advise you the following:
Tests of blood, particularly for urea, creatitine, Serum proteins, CBC.
Re-test of urine and if it shows Leukocytes, it is better to get urine culture and sensitivity done.
Ultrasonography of the whole abdomen, particularly for urogenital system.
Levocetirizine to be taken only if required.
To reduce the dose of Sertraline if possible, 100 looks to heavy.
Try to have sound sleep of 8 hours.
I hope this answer helps you, Let us see the reports first to decide the further course of actions as the medicines would definitely be dependent upon the findings of the reports and clinical evaluation.
Please feel free to post the old and the new reports so that it helps me to assist you better and ask for further relevant queries if you feel that there is a gap of communication .
As discussed in details below.
Detailed Answer:
Hi.
Thanks for your query and an elucidate history:
To recapitulate: Female/22 - professional Nurse - stable partner - swelling in the eyes - 2 months - tired, confused and whiter skin than before - lower back ache - noted history about Mother - Zoloft 100 since Aug - allergic to molds since the age of 4 and takes Levocetirizine - also helped for soggy eye in past - raised erythrocyte, leukocyte and epithelial count in urine tested in Lab - but normal when done at GP - wants best course of action - not sure whether to visit a Nephrologist ...
As per the history you have provide, this looks to be a combination of many reasons as follows:
The swollen eyes can be due to an allergy as you have mentioned or can be due to effects of Sertraline and/or Levocetirizine. For knowing further you need to have additional investigations.
Tiredness, feeling confused and whiter skin can be secondary to the primary problem.
Lower back ache at your age is usually due to wrong postures, muscular spasms and so on.
I would advise you the following:
Tests of blood, particularly for urea, creatitine, Serum proteins, CBC.
Re-test of urine and if it shows Leukocytes, it is better to get urine culture and sensitivity done.
Ultrasonography of the whole abdomen, particularly for urogenital system.
Levocetirizine to be taken only if required.
To reduce the dose of Sertraline if possible, 100 looks to heavy.
Try to have sound sleep of 8 hours.
I hope this answer helps you, Let us see the reports first to decide the further course of actions as the medicines would definitely be dependent upon the findings of the reports and clinical evaluation.
Please feel free to post the old and the new reports so that it helps me to assist you better and ask for further relevant queries if you feel that there is a gap of communication .
Note: For further queries related to kidney problems and comprehensive renal care, talk to a Nephrologist. Click here to Book a Consultation.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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