QUERY:
In the past 4-5 yrs. any increase in body temperature (even slightly)
ex.. wearing a sweater, drinking hot coffee, going inside during the winter
or working inside all day if its too warm...
causes my hands to swell and turn very red. It's almost painful.
Now I'm noticing my feet are doing this as well. I haven't always been this
way, I used to wear sweaters constantly,sleep with an electric blanket. Now I
can't go in the sun in moderate heat with out being miserable. My doctors
ran some tests, Its not diabetes, thyroid disorder, blood pressure, or
glandular related, so they say. My allergies are, sulfa, shellfish, codiene
& iodine. I'm feeling rather dysfunctional. The meds I take daily
are amoxicillian (for acne) 1 and 1/2 yrs. Celexa 30 mg for 8 months. If
the temp decreases I am not as miserable, but still not normal. This is
getting very frustrating and the doctors think I'm looney . I'm getting
scared, It's very uncomfortable and is keeping me from being in a lot of
situations.
ANSWER:
I'm glad you are pursuing the answers for your problem, especially since it
seems to be getting worse with time. So far, so good - the thyroid,
diabetes, and glandular checks are all okay. I'll try to give you some more
ideas to share with your doctors. Actually, there is one particular
syndrome that fits your symptoms so I want to tell you about it in depth and
ask you to check with your physician for some further evaluations.
The symptoms you describe are classic for something called
erythromelalgia, which literally means red, painful extremities.
Erythromelalgia is not a commonly recognized or diagnosed condition. The
first reported case was in 1878.
Erythromelalgia is a chronic disorder characterized by intermittent burning
pain, warmth and redness of the extremities. Increasing the local
temperature and dependency of the affected limbs precipitates the symptoms,
whereas direct cooling and elevation of the limbs can provide partial
relief. The reasons for this are not that well understood and are still
being researched. The symptoms may occur in "attacks" that last for minutes
to hours and occasionally days and are precipitated by a warm environment.
People with this seek relief by exposing the affected extremity to a cooler
environment, such as placing the extremity in cold water, walking on a cold
floor barefoot, or running the air conditioner even in the winter.
Sometimes there is no underlying cause - it just *is* and that's all. In
these cases it may run in families. However, there is a secondary category
that is associated with other diseases, the most common being blood
disorders such as 'polycythemia vera' and 'essential thrombocythemia'. There
are also other diseases that can be associated with this and a good
hematologist, neurologist, or a rheumatologist should be able to rule these out for you.
Erythromelalgia may also result from therapy with various drugs
(nifedipine, nicardipine, verapamil, bromocriptine, and pergolide).
The treatment of erythromelalgia is often difficult and frustrating. In
secondary erythromelalgia, treatment of the underlying problem may relieve
the symptoms. Aspirin is often used. Other therapies with variable success
include methysergide, ephedrine, non-steroidal anti-inflammatory drugs,
phenoxybenzamine, nitroglycerine, sodium nitroprusside, corticosteroids, and
surgical sympathectomy.
Of course, I do not know that this is what you have, but your symptoms sure
sound like you should ask your doctor to check it out with you. It would be
important to have someone follow this with you to prevent any long term
problems.