A 20 years of age male patient presented in todays'medical OPD with progressive generalized body swelling for the past one year.
Systemic inquiry was unremarkable. Examination including blood pressure was normal except for pitting pedal edema up to the knees.
What diagnosis should we consider in this patient?
Considering presenting complain of generalized body swelling diffrentials Like.
Nephrotic syndrome,
Congestive cardiac failure
CKD
Malabsorption,
Chronic liver disease
Cor-pulmonale
Hypothyroidism
Lymphedema should be kept in mind.
*As this patient have no history of sob,orthopnea, and PND and jvp is not raised on examination so heart failure is less likely as possibility.
*Patient have no history of jaundice and no stigmata of chronic liver disease on examination so cld is also less likely.
*No history of uremic symptoms like anorexia,nausea ,vomiting,nocturia,&hematuria and normal blood pressure on examination ckd and nephritis is also less likely.
*No history of cough dyspnea hemoptysis and ,cold intolerance constipation,change in voice so corpulmonale & Hypothyroidism is also less likely.
*Patient also have no complains of chronic diarrhea,weight loss,poor dietry intake so malabsorption is also less likely.
*lymphedema will cause painless localised swelling so it is less likely as this patient have generalized swelling.
*Generalized body edema with no remarkable systemic history and pitting edema upto knees, and normal blood pressure nephrotic seems to be top differential.
About cause of nephrotic syndrome patient should asked for history of recent sore throat,or viral infection,medications history,history of connective tissue disorders(fever, jointpain,rash,mouth ulcers,photosensitivity)& family history of renal diseases.
What tests are required to confirm the diagnosis of Nephrotic Syndrome?
Done to identify cause of nephrotic
A renal biopsy is not indicated in adults with nephrotic syndrome from an obvious cause.for example longstanding diabetesperformed in cases with.