Dyspnea, Elevated Jugular Venous Pulse, and Lower Extremity

Chest · Sep 2021

Case Reports

Dyspnea, Elevated Jugular Venous Pulse, and Lower Extremity Edema in the Setting of Interstitial Lung Disease in a Patient Who Has Undergone Liver and Kidney Transplantation.

A 64-year-old man with a past medical history of alcoholic cirrhosis with resultant hepatorenal syndrome requiring kidney and liver transplantation 10 years previously sought treatment at the ED with progressive lower-extremity edema and dyspnea. After noting worsening shortness of breath and cough as an outpatient, he had been referred to a pulmonary clinic and was undergoing a workup for interstitial lung disease (ILD). ⋯ He was also receiving chronic immunosuppression with tacrolimus and mycophenolate mofetil. He had noted worsening of edema since starting prednisone.

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- Reema Qureshi, Yevgeny Vayntrub, Bassam Aswad, Gaurav Choudhary, and Matthew Jankowich.
- Division of Cardiology, Providence VA Medical Center, Providence, RI; Division of Cardiology, Alpert Medical School of Brown University, Providence, RI.
- Chest. 2021 Sep 1; 160 (3): e295-e298.
Case PresentationA 64-year-old man with a past medical history of alcoholic cirrhosis with resultant hepatorenal syndrome requiring kidney and liver transplantation 10 years previously sought treatment at the ED with progressive lower-extremity edema and dyspnea. After noting worsening shortness of breath and cough as an outpatient, he had been referred to a pulmonary clinic and was undergoing a workup for interstitial lung disease (ILD). He had been started on prednisone 40 mg/d after a lung biopsy 4 months before admission. He was also receiving chronic immunosuppression with tacrolimus and mycophenolate mofetil. He had noted worsening of edema since starting prednisone.Published by Elsevier Inc.

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Dyspnea, Elevated Jugular Venous Pulse, and Lower Extremity Edema in the Setting of Interstitial Lung Disease in a Patient Who Has Undergone Liver and Kidney Transplantation.

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