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Electronic letters published:
![[Read Comment]](/icons/misc/sectionDOWN.gif){kind=icon}
Authors Respond to Comments on Panic Attacks as Cause of Hot Flashes
Underlying panic disorder?
OKPRN Study
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James W. Mold, Oklahoma City, OK, USA Univ. of Oklahoma HSC
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Since we were using an existing database, we could not include more specific questions about panic attacks. We agree that they are probably an important cause of hot flashes and perhaps night sweats and day sweats. Competing interests: None declared |
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David A Katerndahl, San Antonio, USA University of Texas, Health Science Center at San Antonio
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I wish to complement Mold et al on their investigations on sweats and hot flashes. We desperately need more such symptom-based PBRN studies. One point that was insufficinetly emphasized (in my opinion) was the potential role of panic disorder in these results. Despite the association in their previous study, they did not specifically ask about panic attacks. Yet, their findings may be due in large part to coexisting panic. Not only are both sweats and hot flashes part of the criteria for panic attacks, but several of the associated variables (numbness in hands and feet, lightheadedness, nervous spells) are as well. In addition, the noted relationship between depression and night sweats may, in fact, be due to an unrecognized but common association between depression and panic disorder. As good as this study is, it might have been even more helpful if panic disorder had been specifically addressed in data collection. Competing interests: None declared |
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Lawrence I. Silverberg, Ellicott City, U.S.A. Philadelphia College of Osteopathic Medicine
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My compliments to the authors of this study. Not only is the methodology impressive but they have undertaken the task of exploring important symptomatology to the primary care physician. Although this article was not intended as the discussion of the differential diagnosis, I want to mention the disease of Polycythemia Vera when considering etiologies. From a study done at Johns Hopkins it appears even hematologists fail to consider this orphan disease when its symptomatology presents. Due to be enormous erythroid turnover, iron deficiency with its accompanying symptoms can occur. Aquatic pruritus and the erythromyalgia frequently occur. In that the population mentioned here is of high risk, and immediate treatment essential for PV I would like to advocate for consideration in the differential diagnosis. I continue to enjoy exploring The Annals Of Family Medicine. LIS Competing interests: None declared |
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