Clinical Case Database / Category: Case Based Discussion

Nephrotic syndrome

Publication details

Dr Amar S Bhat MBBS, Dr Smita S Gunda MBBS MRCP
Foundation Years Journal, volume 2, issue 10, p.416 (123Doc Education, London, December 2008)


A 54-year-old gentleman presented to the renal clinic complaining of increasing swelling of 6 to 8 weeks duration, mainly in his legs and around his eyes. He had gained four kilogrammes of weight. He had no history of upper respiratory tract infection or any other illness preceding these symptoms. He did not give a history of rash, haemoptysis, joint pains, nose bleeds or hearing problems. He was started on furosemide by his GP with no response. He had a past history of well controlled hypertension and asthma. At the time of presentation he was on lisinopril, cetrizine, salbutamol inhalers and salmeterol inhalers. He smoked about 30 to 40 cigarettes per day. On examination, he had a pulse of 86 bpm and his blood pressure was 133/95 mmHg. His JVP was not raised. He had gross bilateral pitting pedal oedema extending up to the abdominal wall. The rest of the general and systemic examination was unremarkable.

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Dr Amar S Bhat MBBS

Core Medical Trainee currently in Renal Medicine
Queen Elizabeth Hospital
King’s Lynn
Norfolk, UK

Dr Smita S Gunda MBBS MRCP (Corresponding author)

Consultant Nephrologist
Queen Elizabeth Hospital
Gayton Road
King’s Lynn
PE30 4ET
also Addenbrookes Hospital, Cambridge, UK


1. Johnson RJ, Feehally J. Comprehensive Clinical Nephrology, 1999, Moseby.
2. Steddon S, Ashman N, Chesser A, Cunningham J. Oxford Handbook of Nephrology and Hypertension, 2006, OUP Oxford.
3. Kelepouris E, Agus ZS, Glassock RJ, Sheridan AM. Available at


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T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

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