28year old male with complaints of SOB,pedal edema and abdominal distension

January 17, 2021

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Here is a case I have seen

28 year old man, came to opd on 5 dec 2020 with c/o sob since 3 days already a known case of hypertensive since 12 months,ckd on mhd , non diabetic, non alcoholic, non smoker, unmarried, constructor worker from Nalgonda who was apparently alright, busy working daily at construction sites one day an year back developed high grade fever along with body pains for which he was taken to a RMP and he was given ' tablets for fever ' as the attendant describes it, which got subsided temporarily. By night he again developed fever for which he was taken to Nalgonda Hospital and was admitted for a few days and was discharged.

Since then he was on regular NSAID use for fever and body pains.

After 4months he again developed fever and he was taken to NIMS where they performed a Renal biopsy and told them his kidneys got affected because of overuse of painkillers.

Biopsy report

2 months later he developed Dyspnea at rest, reduced urine output, non productive cough, he developed even pedal edema which slowly crawled up to his abdomen cause its distension along with facial puffiness. Upon examination they were told that he had hypertension and was started on antihypertensives and that he needed hemodialysis.

During his stay in the hospital a pleural tap was done and his sputum cultures were sent too. They were negative for tuberculosis.

On examination, pallor is present