Case: An 83 year old woman arrived in clinician’s office complaining of pruritic “hives” (small red bumps) one day ago on trunk and thighs accompanied by nausea and lightheadedness. Her left eyelid also became swollen. Symptoms occurred at rest and lasted two hours. The swelling of her eyelid lasted a bit longer than the bumps on her trunk and thighs. Her lightheadedness represented presyncope. She had many similar episodes in the past six months.
During one episode, she had syncope and was hospitalized. She was diagnosed with orthostatic hypotension. Social History Her family believes that she has been under unusual emotional stress and believes that stress is contributing to her current presentation. She moved from her home to a life care community six months ago and has been anxious and unhappy. She moved to Baltimore from Southern California one week ago. What is the possible…
