Clinical and Medical Case Reports

Biography

Biography: Niraj Khatri Sapkota

Abstract

Background: Edema is general symptomatic feature of different organ failure or due to malnutrition or in sometimes due to long stand especially during summer with , heavy weight bearing, vasodilatation, or cardio-hepato-renal disease or in rare hypothyroidism, but in atypical case could demonstrates depression with progressive stress also shows indication of mild pitting edema.

Case presentation: This is a case of middle age divorced male under depression who is under medication since 10 years complained of weight gain almost 10kg in 30 days duration, less attentive to his work and always feel sleepiness during day (once get to sleep, slept more than 5 hours during day) and also late upto morning if not called to wake-up, also with diminished memory, more specific event was before 60 days of these symptoms he unexpectedly suffered family tragedy.

Test and result; He performed all the test that possibly could lead to diagnosis of foot edema echocardiography, ECG, Creatinine clearance, total protein, albumin and finally thyroid function test  but all test were normal  except high 24 hours  creatinine clearance  therefore no any medication were prescribed, on counseling  and motivation  all his symptoms slowly disappeared  in 45  days duration.

Conclusion; This case is rarest presentation of depression led progressive stress pitting edema that got managed after appropriate counseling along with changes in his life style.