ANASARCA SECONDARY TO ?NEPHROTIC SYNDROME










This is online E-blog, to discuss our patient de-identified health data shared after taking her guardian's signed informed consent.




Here we discuss our individual patient problems through series of inputs from  available global online community of experts with an aim to solve the patients clinical problem with current best evidence based input.




This E-blog also reflects my patient's centred online learning portfolio. 

A 13years old girl who is a student studying in hostel located at annaram,came with complaints of  Bilateral lower limb swelling since 15days. 

HOPI:Patient was apparantly normal 2months back and then she developed nausea and vomitings 4 episodes for 3 days.content food particles.Non bilious.Not associated with pain abdomen.No loose stools.Now since 15 days patient developed bilateral lower limb swelling initially till ankle and now progressed to generalised swelling with puffiness of face.

History of migratory joint pains ,1 month back

Gross hematuria on the day of admission,later it was pale yellow after rehydration with fluids 

No history of SOB,No burning micturition,No fever,No skin rashes.

History of irregular menstrual cycles since menarche (achieved her menarche at 12 years)menstrual cycles were once in every 3 months.Last menstrual period 30/05/2022.

Not a known case odf DM,HTN,THYROID,CAD,CVA,BRONCHIAL ASTHMA.

History of acute gastroenteritis 2 months back.o

GENERAL EXAMINATION: 

Bilateral pitting type of pedal edema present 

NO PALLOR,ICTERUS,CYANOSIS,CLUBBING,KOILONYCHIA,LYMPHADENOPATHY.











VITALS:

Bp:110/80mmHg in left arm in sitting position 

PR:78bpm

RR:16Cpm

BAE present.NVBS Present 

CVS:S1S2 heard

CNS:NAD

Temperature:Afebrile

JVP:Not elevated 

Day 1 Input/Output:500/350ml

Day 2 input /output 900/700ml

On day 3 input/output 800/750ml

ASO titre negative 

Serum C3 and C4 negative 











PROVISIONAL DIAGNOSIS:ANASARCA SECONDARY TO ?NEPHROTIC SYNDROME 
TREATMENT:
1)Monitoring Bp,PR,Temperature.





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