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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Hypertension, Swelling In Ankles, Ovarian Mass. What Is Cause And Possible Cure?

Hi there. Wondering if you could give some suggestions for my sister. She is 34 yr old with 7 children. Never any health issues in past with exception of hypertension with the first pregnancy. At the beginning of March she started to notice swelling of ankles and feet. Got progressively worse to include hands face ( eyes are sometimes half swollen shut ) abdomen and hips. Bloodwork - Thyroid low and Albumin 18. Liver Function normal. She was referred to endocrinologist diagnosed Hashimotos. Swelling did not resolve after starting thyroid med. and hctz. doctor ordered ultrasound. Showed ovarian mass. She just had ct scan which ruled out mass. Stated three times in report that ovaries are unremarkable, ruled out mass. All other organs also normal and unremarkable She still has major edema. I went with her to hosp emerge and she has low albumin (18) but all the other standard tests came back normal. Voiding small amounts of concentrated urine. Protein in urine is 3+. Ascitic Fluid was clear pale. She has gained 25lbs of fluid.
Fri, 28 Jun 2013
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General & Family Physician 's  Response
Hello,
Thanks for the query to H.C.M.Forum.
Liver function tests are normal including major tests .
Normal amount of albumin is 35-55 gm/ L.
In your sister it is 18 gm/liter.
Protein is also passing in the urine as shown +++ ( this is also a type of albumin).
Now main cause of generalized edema is HYPOPROTENAEMIA ( HYPOALBUMINAEMIA ) .
Mal-absorption is one most prominent cause.
As you mentioned that she was a patient of hypertension , so diagnosis is somewhat clear that may be,
Chronic renal failure,
Malabsorption,
anemia ,
Tuberculosis
So consult a physician and get his opinion along urologist .
Hope I have answered your question.
If further any question I will help.
Good luck.
Dr. HET
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Hypertension, Swelling In Ankles, Ovarian Mass. What Is Cause And Possible Cure?

Hello, Thanks for the query to H.C.M.Forum. Liver function tests are normal including major tests . Normal amount of albumin is 35-55 gm/ L. In your sister it is 18 gm/liter. Protein is also passing in the urine as shown +++ ( this is also a type of albumin). Now main cause of generalized edema is HYPOPROTENAEMIA ( HYPOALBUMINAEMIA ) . Mal-absorption is one most prominent cause. As you mentioned that she was a patient of hypertension , so diagnosis is somewhat clear that may be, Chronic renal failure, Malabsorption, anemia , Tuberculosis So consult a physician and get his opinion along urologist . Hope I have answered your question. If further any question I will help. Good luck. Dr. HET