Graves disease with odd symptoms?

[ekunath]

I was diagnosed with hyperthyroidism & Graves disease 5 years ago, but am currently not treated for it. I had a large nodule biopsied 3 years ago (it had been growing) and it came back normal. My levels have not been terrible for the past few years, so there was no reason to treat. I am now having a medical issue that started 5/1/2012 with a very sudden onset, but my endocrinologist does not think it's related.

What's going on: left-sided body swelling (left cheek, left eye, left jaw, left breast, left leg)- facial swelling is worse in the morning & leg swelling is worse after prolonged sitting/standing, constant since the onset; left arm routinely goes completely numb at night & takes about 10-20 minutes to regain feeling; left ear occasionally loses hearing (very briefly-fades out & fades back in very quickly with a ringing sound); shooting pain and tingly feeling up left leg & left foot (when sitting for long periods); chills & goose bumps down left side only (mostly left thigh) or alternately, the left leg feels hot to the touch, petechiae has been developing around my eyes (new symptom) and tiny bright red dots scattered on left leg (definitely not freckles or pimples, maybe petechiae?); night sweats; fatigue & headaches with pressure around bottom half of the back of my head (could be unrelated?).

What's been done: venous ultrasound of the leg to check for blood clot (done May 2nd), chest x-ray, MRI/MRA brain/neck, MRI c-spine. Evaluated by neurologist & endocrinologist; neither thought it was related to their specialty. Primary recommended discontinuing birth control; I've been off of it for over 3 weeks and there has been no change. I've been tachycardic, between 110-130 and my blood pressure has been elevated.

Do you think this could be related to Graves disease at all? Or can that be ruled out?

[ekunath]

Thank you so much, Dr. Lupo, for taking the time to answer my question. My CBC was normal; only low RBCs. I will ask my doctor about rheumatology; I had never even heard of that; thank you for the suggestion!

[Mark Lupo, M.D.]

This is atypical for Graves.  i would be concerned about bleeding disorder (if these are petechiae) -- I assume CBC was done and was ok?  If your thyroid levels have only been mildly hyper and stable, it would not explain sudden onset of these symtpoms. Vasculitis could do this - given that you have autoimmune thyroid disease, a rheumatology evaluation for other autoimmune problems may be warranted.