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Suggest Treatment For Indented Legs, Water Retention And Fatty Liver

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Posted on Mon, 31 Aug 2015
Question: Hello Doctors,

I am 47 Year Old and with 77 Kgs Weight. Blood Pressure remains between 76 - 120. Normal Sugar level is around 96-99. Cholestrol is normal. But Triglicerides is around 257.

I have never smoked nor drunk Alchohol in my life. I have Alergic Asthama.. (Breathing Problems) and i use Inhaler when needed during Cold and Dusty Conditions.

I am a Vegetarian and have Chicken once or twice in a year.

Use to intake more Cough Syrups due to Bronchitis problems...can this be the reason for fatty lever.

Now i have been having Indented legs. When i press somewhere it remains as it is for long time. Test says i have a fatty lever. This was discovered when i started using stairs for 5 floors daily.

What could be the reason and let me know possible remedy.

Thanks and Regards
XXXXXXX

doctor
Answered by Dr. Drkaushal85 (35 minutes later)
Brief Answer:
Get done 2d echo for the diagnosis of Pulmonary hypertension.

Detailed Answer:
Thanks for your question on Health Care Magic.
I can understand your concern.
Since you are having bronchitis and allergic asthma, possibility of Pulmonary hypertension is more.
It is mostly due to right sided heart disease caused primarily by lung disorder.
In this fluid over load occurs. And excess fluid accumulate in lower limbs and cause pitting edema.
So better to get done 2d echo for the diagnosis of Pulmonary hypertension.
Hope I have solved your query.
I will be happy to help you further.
Wish you good health. Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Drkaushal85 (6 minutes later)
Thanks Doctor.

But, My Physician says Heart is normal and dont you think the Fatty Lever might have caused this or will Fatty Lever will be dangerous?.

Will get the test done. Any remedy to reduce fat in lever?.


Thanks and Regards

XXXX

And further Lungs are also normal.

I get bronchitis only during Severe Cold conditions (Winter) and breathing allergy to Dusty Conditions.
doctor
Answered by Dr. Drkaushal85 (16 hours later)
Brief Answer:
what is your height?

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
Fatty liver is due to excess fat accumulation on liver.
And it can not cause pitting edema without altering liver functions like low protein, low hemoglobin level etc.
So please let me know if you had protein and hemoglobin estimation done.
Also let me know your height.
I will be happy to help you further.
Wish you good health. Thanks.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Drkaushal85 (7 hours later)
Dear Doctor,

Thanks for your reply.

I am 179 (5.8+ inch) Cm Tall. Haemoglobin level is 15.63 gm/dl, WBC count: 7300 C/cu, RBC Count: 5.33 M/Cu, HCT/PCT 45.11, MCV 84.63 fl, MCH 29.33 pg, MCHC 34.65 gm/dl, Platelet: 2.52 L/Cu, ESR: 20 MM 1st hr, Neutrophils: 59, Lymphocytes: 28, Eosinphils 11, Monocy: 02, Basophil: 00, RDW-CV: 12.33, PDW: 12.25, MPV: 7.94, PCT: 0.2.
Fasting Glu: Plasma : 92 mg/dl, Total choles: Serum: 193 mg/dl, Triglycerides Serum: 267 mg/dl, HDL Chole: 43 mg/dl, VlDl Chol: 53mg/dl, TC/hdl/ratio: 4.5, LDL/HDL Ratio: 2.3,
Renal Function Test: Blood Urea: 23 mg/dl, Creatinine: 0.9 mg/dl (done on Vitros 250 dry chem analyzer)
Thyroid Profile: Tri-iod total: 99.6 mg/dl, Thyroxine total: 4.88, Thyroid simulating Hormone: 0.981.

Realtime Ultrasound Scanning:

Lever shows diffuse increase in echogenectiy.
Parenchymal echotexture is normal.No IHBD
No focal lesion seen

Gall bladder is normal: No Calcui seen wall thickness is normal
Portal vein & CBD is normal
Pancreas is normal in size and texture.

Right Kidney measures 9.6 X 1.4 cms. (cortex)
Right Kidney is normal in size and texture
Parenchymal echotexture is normal
Cortio-medullary differentiation is well made out
No Calculus or hydronephrosis seen

Left Kidney measures 9.6 X 1.5 cms. (cortex)
Leftt Kidney is normal in size and texture
Parenchymal echotexture is normal
Cortio-medullary differentiation is well made out
No Calculus or hydronephrosis seen

Spleen is normal in size and texture.
Aortic & Para-aortic regions are normal.

MALE:
Urinary bladder is normal.
Prostate is normal in size and texture. Seminal vesicles are normal.
No free fluid seen in the abdomen.
No pleural or pericardial effusion seen.

After medication since a week now the problem is reduced and legs and lower parts seems to be returning to normal position, i.e, fatness is reduced by 90% and the Thickness depth which used to be more than 6 mm is reduced by less than 2 mm.

Thanks for your patience.

Further, let me know if i should get protein test done.
doctor
Answered by Dr. Drkaushal85 (3 hours later)
Brief Answer:
are you having breathlessness on exertion like climbing stairs?

Detailed Answer:
Thanks for your follow up question on HCM.
I can understand your concern.
Thanks for the detailed reports.
Surprisingly, you have not undergone any liver function tests despite of having abnormality in liver on ultrasound.
So in my opinion, you should get done liver function test. This includes bilirubin, SGOT, SGPT and protein levels.
Also let me know if you had any of these tests.
Also tell me
1. Are you having breathlessness on exertion like climbing stairs?
2. Which inhaler you use?
Please reply me answers of above asked questions, so that I can guide you better.
I will be happy to help you further.
Wish you good health. Thanks.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
Answered by
Dr.
Dr. Drkaushal85

Pulmonologist

Practicing since :2008

Answered : 15003 Questions

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Suggest Treatment For Indented Legs, Water Retention And Fatty Liver

Brief Answer: Get done 2d echo for the diagnosis of Pulmonary hypertension. Detailed Answer: Thanks for your question on Health Care Magic. I can understand your concern. Since you are having bronchitis and allergic asthma, possibility of Pulmonary hypertension is more. It is mostly due to right sided heart disease caused primarily by lung disorder. In this fluid over load occurs. And excess fluid accumulate in lower limbs and cause pitting edema. So better to get done 2d echo for the diagnosis of Pulmonary hypertension. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.