Brief Answer:
Cause of symptomatology and need of more history

Detailed Answer:
Hi XXXX, thanks for asking from HCM.


I can understand your concern. She is suffering from symptoms involving multiple system of body. Such is possible due to either multiple disease at a time or single multi systemic illness. The following are the possibilities

: Nephropathy - Kidney disease can cause swelling of body parts, weakness due to electrolyte imbalance/anaemia, memory loss and degeneration due to age related atrophy/electrolyte imbalance/encephalopathy. If she is a known diabetic, you must rule out "Diabetic Nephropathy".

: Chronic liver disease - All these symptoms can occur due to liver damage for long duration. It will also cause severe fatigue, rashes due to coagulation problems, swelling, hepatic encephalopathy (Brain symptoms).
The cause can be alcohol intake, viral hepatitis in past, drug toxicity.

: Deficiency disease - Deficiency of iron, folic acid, B12, proteins all can cause such symptoms. If she is not eating properly or she was ill in past, deficiency of all these can happen.

: Fever with rash - Viral fever/some bacterial infection can cause weakness, rashes, swelling due to capillary leak, electrolyte imbalance and all above symptoms. It can be suspected only if fever is documented.

To confirm diagnosis, she should by investigated by
: Ultrasound of kidney, liver

: Urine examination

: Serum electrolytes

: Blood count, hemoglobin

: Peripheral smear

: Liver function test with coagulation profile

: Blood sugar level

: In case of fever, blood culture

: MRI brain to know about encephalopathy

I can help you in excluding few diagnosis if you can provide me more details of illness like

: What is the duration of symptoms?
: Any history of past chronic illness?
: Any history of diabetes, regular medication?
: Any history of fever?
: Is any history of depression?
: Is she ever investigated?
: Any history of urine problems, kidney illness?
: Any history of jaundice, liver disease, alcohol?

Hope you will get my point. If still in doubt, do let me know.
Thanks. Take care

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