Low body temperature
My daughter is having "freezing episodes" every day where her body temp is falling to between 93.2-96 for about an hour at a time. During this spell, her heart rate falls to between 37-44. She also gets a rash-y texture on her cheeks. She has flushing a lot but this is different with the rash-like appearance (see pic).
She had transsphenoidal surgery a year ago for what was believed to be Cyclical Cushing's disease but it was not a success and she still has all the symptoms she had BEFORE surgery plus worsening symptoms. She had had high AM cortisol draws, didn't suppress one dex test with a 7.56 & 5 high 24 hr UFC's... but the neurosurgeons we've consulted aren't certain enough that it is her pituitary to do a second surgery. To make things a bit trickier, her dad had a pheochromocytoma at age 17 and other paternal relatives also had neuroendocrine tumors. I did find a link where pheochromocytomas can cause temperature dysregulation. However, she's had three different metanephrine blood draws and none have been high.
Anyways, back to the freezing episodes - they started as early as November but have increased in frequency lately to several a day and none of her doctors seem to know what to think of them. It is very worrisome to me as it seems like her body is shutting down when they happen. The only thing I can find is that maybe she's experiencing adrenal insufficiency? But, to make it even more confusing, she still has episodes of HIGH cortisol. It seems like she is swinging from low to high or high to low DURING these freezing spells. She has plenty of other symptoms but I'm trying to not write a book. Thankfully her endo has ordered a gallium 68 scan but we are waiting on insurance approval. We did apply to Mayo Clinic but they turned her down as they said they had too many patients right now.
Sooo, does anyone have any idea about these freezing episodes? Thanks in advance!!
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Thank you so much for your response. I’m so glad your daughter is doing better! So the surgeon did remove what he thought was the tumor, but it didn’t stain for acth & her levels didn’t fall. Anyways, I’ve taken her to MGH in Boston & the neuroendo we saw was very dismissive- said her highs weren’t high enough. After hearing all of her symptoms, told me to take her to a Gastro. It was a very disheartening apt. Dr. Friedman from California, does think she still has Cushings Disease & does see a new tumor. However, we have to find a surgeon we would trust. We’ve been busy ruling out anything else causing her symptoms before we subject her to a second surgery.
Who was your daughter’s endo & surgeon at UVA?
@smccoll -
The Endocrinologist at UVA was Mary Lee Vance- superb. The surgeon, Dr Oldfield, died unexpectedly. He was also extraordinary.
I hear that Dr Friedman also is excellent.
When we were looking for a pituitary team we also considered NIH.
Did you try Mayo Clinic?