What is the diagnosis for a 20-year-old experiencing peripheral vasospasm (cold hands and feet), abdominal pain (possibly hepatomegaly or liver dysfunction), and dissociative symptoms (feeling disconnected from their body) that began after smoking legal cannabis (marijuana) 9 months ago?

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Differential Diagnosis

  • Single most likely diagnosis
    • Cannabis-induced panic disorder or anxiety disorder: The patient's symptoms started after smoking legal weed, and the feeling of being "not in his body" could be related to depersonalization, a common symptom in anxiety disorders.
  • Other Likely diagnoses
    • Hypothyroidism: Cold hands and feet, as well as pain in the liver, could be related to hypothyroidism, which can cause a range of systemic symptoms.
    • Anxiety disorder (not specifically cannabis-induced): The patient's symptoms, such as cold hands and feet, could be related to anxiety, which can cause vasospasm and other physiological symptoms.
    • Depression with somatic symptoms: The patient's symptoms, such as pain in the liver, could be related to depression, which can cause a range of somatic symptoms.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Endocarditis: Although unlikely, the patient's symptoms, such as pain in the liver, could be related to endocarditis, which can cause embolic phenomena and systemic symptoms.
    • Vasculitis: The patient's symptoms, such as cold hands and feet, could be related to vasculitis, which can cause a range of systemic symptoms and can be life-threatening if not treated promptly.
    • Pheochromocytoma: Although rare, the patient's symptoms, such as cold hands and feet, could be related to pheochromocytoma, which can cause episodic hypertension and other systemic symptoms.
  • Rare diagnoses
    • Mitochondrial myopathy: The patient's symptoms, such as cold hands and feet, could be related to a mitochondrial myopathy, which can cause a range of systemic symptoms and can be difficult to diagnose.
    • Porphyria: The patient's symptoms, such as pain in the liver, could be related to porphyria, which can cause a range of systemic symptoms and can be life-threatening if not treated promptly.
    • Complex regional pain syndrome: The patient's symptoms, such as cold hands and feet, could be related to complex regional pain syndrome, which can cause a range of systemic symptoms and can be difficult to diagnose.

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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