Weight loss and dizziness in a 29-year-old man

• Medical history: Seasonal allergies, recent mild depression.


• Surgical history: Stab wound to left side of chest 6 months prior and subsequent left diaphragmatic hernia repair 2 months prior.


• Medications: Cetirizine 10 mg once a day, cyclizine 50 mg 3 times a day, acetaminophen 1 g every 6 hours when required.


• Allergies: None known


• Family history: Mother had primary hypothyroidism, father had COPD.


• Social history: Patient works as a builder, is married with two children age 3 years and 6 years. He smokes 1 pack of cigarettes per day for 10 years, drinks on average 4 to 6 beers per week, and denies use of recreational drugs. There is no history of recent travel abroad or contact with people with illness or infection.