Clinical Question: How to Approach a Patient Presenting With Sweating and Flushing

Area of Science:

• Endocrinology
• Oncology
• Neurology

Background:

• Sweating and flushing are common symptoms, often prompting primary care referrals.
• While typically physiological, these symptoms can indicate underlying endocrine diseases.
• Common endocrine causes include blood glucose fluctuations, hypogonadism, and thyroid dysfunction.

Purpose of the Study:

• To review endocrine pathologies associated with sweating and flushing.
• To highlight rarer endocrine causes requiring clinical suspicion.
• To guide the diagnostic and management approach for these symptoms.

Main Methods:

• Literature review of endocrine disorders presenting with sweating and flushing.
• Analysis of common and rare endocrinopathies.
• Discussion of diagnostic considerations and management strategies.

Main Results:

• Common endocrinopathies include glucose, hypogonadism, and thyroid dysfunction.
• Rarer causes include phaeochromocytoma/paraganglioma (PPGL) and neuroendocrine tumors (NETs).
• Family history of germline mutations increases suspicion for rare endocrinopathies.

Conclusions:

• Endocrine evaluation is crucial for unexplained sweating and flushing.
• Consider rarer pathologies like PPGL, NETs, and medullary thyroid carcinoma.
• When endocrine causes are absent, investigate neurological disease, medications, and non-endocrine conditions.