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A 47-year-old Man with Peripheral Edema

Poll

VIDEO: Note marked tumescence in patient’s hands, pitting edema in lower extremities. Does PMH contribute? Dx?

A 47-year-old man presents c/o swelling in extremities-hands x1 week; legs, x1 month. Marked tumescence is seen in the hands and pitting edema is noted on lower legs. PMH: HTN, T2DM, hyperlipidemia; S/P cholecystectomy. Meds: HCTZ; lisinopril; amlodipine; insulin. See differential diagnosis below.

 

What do you suspect as the diagnosis?

Nephritis/nephrotic syndromes
Focal segmental glomerular sclerosis
Lupus nephritis
Membranous nephropathy
Diabetic nephropathy
IgA nephropathy
Amyloidosis
Congestive heart failure
Liver disease
Drug reaction
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