Pt: 7/F c/c: dysnia, BLN, Fever oedema, generalised body oedema from last 6 weeks, o/e: BP: 90/ 50, pulse 65 spo2 96 suborbital oedema, pallor++, weakness in lower limbs, patellar reflex absent, patient unable to stand, TLC 7200, HB 10.1 KFT: sr cr 0,6 BUN 26,4 Total pr 4,9 Albumin 2,8

2 Likes

LikeAnswersShare

Most propably Hypothyroidism Anasarca Pericardial effusion... Proximal myopathy due to hypothyroidsm.. Ecg..poor quality..plz post the clear picture.. Adv.. Echo.. Thyroid profile.. Cbc.. Fever..may b due to ? Left lower zone consolidation in x ray with massive cardiomegaly...

@@Dr. Suresh Narayanan Ji according to Ayurvedic we advise if fever come down ,Tab.Shree Jayamangal Ra's fry jeerapouder with honey 1 bd, fever is coming normal than others will be helpful.
0

View 1 other reply

Fever, Edema, Pallor, Patient unable to stand, x 6 weeks. Reflexes Absent. P.R. 65/mit, Spo2 : 96℅ Total Proteins: 4.9 Albumin: 2.8 CXR : PERICARDIAL EFFUSION. ECG : BRADY WITH LOW VOLTAGE. THIS IS A CASE OF HYPO-ALBUMINEMIA, BRADYCARDIA, LOW VOLTAGE WAVES. CNS AFFECTED. WORK UP WITH: CPK LEVELS, EMG. FUNDUS EXAMINATION. CSF ANALYSIS FOR " CYTO-ALBUMINO DISASSOCIATION" DX : G.B SYNDROME. D/D : VIRAL MYOCARDITIS, WITH PERICARDIAL EFFUSION. HYPOTHYROIDISM.

Cas@e of? RPGN,?AIDP Patient has a short history with significant proteinuria Get a Usg,urine routine done Do a CSF if weakness is progressive and look for albumino cytological dissociation CXR shows Cardiomegaly also can be of restrictive etiology Screen out connective tissue disorders also Start with ACE inhibitors,Multivitamin injection specially Vitamin B1 i.e thiamine as can be wet beri beri also which fits in this condition.. Ecg also shows poor progression of R waves so indicative of cardiomyopathy Get urine 24 hrs protein Urine for spot creat Get a central line to monitor CVP and Tab Torsemide to start with after BP stabilises else start with ionotropes Do a urine flowmetry also Review history regarding weakness in lower limbs,ask about bowel bladder involvement..if any sensory symptoms or pure motor.. Reflexes lost..if it is paraplegia in extension or flexion..look for extra pyramidal sign and signs of spinal arc predominance..mention about the posture of the patient also.. Kindly update with further reports

Get a t3,t4,tsh also
0

Edema Pleural pericardial effusion Reduced reflexes ? Myopathy Favour hypothyroidism... But do workup including for nephrotic syndrome, ECHO, LFT..

Clinical pic fits into Hypothyroidism But it must be congenital not due to thyroiditis Delayed diagnosis Pts anthropometric measurements not mentioned Dr Faisal plz update till final diagnosis

Why should hypothyroid have such severe hypoalbuminemia? Please give urinanalysis report and serum cholesterol. I haven't seen myxedema in ped hypothyroid, at best it should be non pitting edema and not anasarca. I haven't come across absent knee jerks. The xray shows both pericardial and pleural effusion which could be part of hypoalbuminemia. The other possibility could be serosotis with nephrotic in a collagen vascular disorder like SLE.

Hypothyroidism Check levels

D/D Hypothyroidism Nephrotic syndrome Pericardial effusion Rx Echo Thyroid profile Urine routine Serum cret. & urea CBC.

HYPOTHYROIDISM Check her thyroid status Her ECG is not clear

Hypothyroidism with complication.

Load more answers

Cases that would interest you