A CASE SERIES ON ANASARCA AS A CLINICAL MANIFESTATIONS OF CHRONIC KIDNEY, LIVER AND HEART DISEASES

Abstract

Anasarca is a condition characterized by severe generalized swelling of the body following accumulated of fluid in the extracellular compartments, It may result from multiple etiology mainly of renal, hepatic, cardiovascular origin and nephrotic syndrome that change the proteins of the body, affect the balance of fluids or create abnormalities in the blood vessels or lymphatic system. This is a case report of anasarca with chronic kidney disease of which 60 year old male patient was admitted in hospital with chief complaints of bilateral lower limb swelling, facial puffiness and abdominal discomfort and distension since 1 month, Patient also had a whole body swelling, breathlessness, orthopnea, cough since 15 days with decreased urine output. So based on patient signs and symptoms. The physician has advised complete blood count, lipid profile test, serum protein, renal function test, liver function test, urine analysis, abdomen pelvic sonography etc, In which CBC, RFT, urine analysis, serum proteins were abnormal. Abdomen pelvic sonography shows left kidney not visualized atrophy, right grade 1 renal parenchymal disease, moderate ascites with bilateral pleural effusion, chronic liver disease and confirmed final diagnosis as anasarca with chronic kidney disease. The treatment was initiated with symptomatic treatment along with first line therapy includes diuretics, iron folic acid, sodium bicarbonates, amlodipine, antiemetic, proton pump inhibitors, vitamin supplements, antibiotics etc. Due to atrophy (failure) of one kidney, patient was advised for dialysis and patient counselling was given. Early identification and treatment of the patient is important and it will lead to better outcomes and hopefully decrease the need for prolonged hospitalization, prevention steps for anasarca by managing the conditions that can cause it and following the physician instructions carefully for changing daily habits and taking medications correctly.