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A 25 yrs old female pt c/o fever on /off since 1 month Decreased urine out , Pedel Edema and puffy face swelling lips Ulcers in oral cavity O/I HB % 7.0 gms , WBC 2,200 .platelets 60,000 RFT s/creat 1.2 B/U 30 Electrolytes. Na+ 132 K+ 3.2 cl 99 N /K/0 Dm , HTN , thyroid Provisional Dx VIRAL PYREXIA WITH TCP ?Anasarca ,anemia ?HYPOTHYROIDISM ?Nephrotic syndrome Dx and treatment plz

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Pancytopenia with fever Causes can be intrinsic causes 1) Intrinsic causes are bone marrow related, causing suppression of all cell line, because of leukemia, lymphoma, myelodysplastic syndromes It requires peripheral smear and bone marrow aspiration Extrinsic causes They can be Viral infections - HIV, Epstein Barr virus, Cytomegalovirus, parvovirus Bacterial infections - Typhoid and shigella Parasitic infection - Malaria and Kala Azar Zoonotic diseases - Brusellosis and Tularaemia Hemolytic disorders - Thrombotic thrombocytopenic purpura, Hemophago lympho histiocytic syndrome, liver disease

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ANEMIA STOMATITIS HYPOPROTEINEMIA THROMBOCYTOPENIA LEUKOPENIA LEADING TO NEPHROPATHY/CKD THESE ALL SEEMS DUE TO SEVERE VIRAL INFECTION TO BE EVALUATED PROPERLY INCLUDING ALL REQUIRED HEMATOLOGICAL INVESTIGATIONS CT ABD-PELVIS USG VIRAL MARKERS INCLUDING DENGUE MALERIA....TO CONCLUDE

Thanks Dr. Kute Ankush
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Why dont you check Thyroid profile first. ?Hypothyrodism. ? Hashimoto..

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Anaemia Hypothyroidism Acute renal failure Need full detailed investigation

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Anemia with hypopriteinemia

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D/D Acute Glomerulonephritis Nephrotic Syndrome Hypoproteinemia With Anemia & global defecincy of vitamins & minerals

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IT'S A..CASE OF.. ? ANEMIA..WITH.. GLOSSITIS-STOMATITIS..& .. HYPOPRITEINEMIA.. ? NEPHROTIC SYNDROME..? CKD .. NEED'S CLINICOPATHOLOGICAL EVALUATION WITH.. * ANEMIA PROFILE .. * URINE ROUTINE.. * LFT..KFT.. * BSR .. * TFT.. USG STUDY ABDOMEN..

Tnx Dr Gyanendranath Tripathy
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Ps do BS for MP,widal,serum protein,LFT, ESR and bone marrow study

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Hypothyroidism with PUO. Needs further investigation and evaluation to conclude and treatment plan. PCM SOS. Clavam cl 625 mg bd. Low salt diet. Multivitamin and antioxidants orally. Green leafy vegetable and plenty of nutritious balanced liquid diet. Till reports complied.

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History suggest pt is renal failure as clinical signs and pmx DM/HTN Probably pt has CKD Thrombocytopenia may be a/w viral fever which excerbated CKD There is hyponatremia Anaemia and early deranged kft

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