I have a 20y/o son who has been diagnosed with isolated systolic hypertension with his BP averaging around 144/76 to 160/76. These spikes in BP seem to "heat related" ie after a hot shower, being outside, physical activity, ect. his resting BP is is around 134/72. He has c/o daily nausea for approximately 3 months, intermittent pain to his RUQ and constant aching to his right lower back. He was hospitalized in August with strep throat, new onset heart murmur, massive headaches, dizziness,high fever, and was diagnosed with CMV. His T4 was at 350. HIV was negative, repeated. Abd ultrasound was negative, cat scan of brain was negative, all other labs were within normal limits. His T4 repeated last month was back up to 1300. But the nausea has continued, along with loss of appetite, night sweats and fatigue. We are repeating labs and abd ultrasound along with UGI next week. I am just looking for anyone who may have insite as to what could be causing this combination of symptoms as they seem to be all over the place and I'm unsure if we're missing something. Any suggestions would be greatly appreciated.