PMC8714915_01
Total body CT: Chest CT showed a marginal pleural effusion and cardiomegaly. Abdominal CT revealed early liver cirrhosis together with fatty change, surface nodularity, and a small amount of ascites. Limb CT revealed severe subcutaneous edema mainly in the lower limb.
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In addition, limb CT revealed severe subcutaneous edema mainly in the lower limb (Figure 1).
Magnetic resonance imaging (MRI) and ultrasonography showed lower limb edema.
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It seemed that his effusion and edema were mainly due to lower limb edema and partially due to pleural effusion, cardiomegaly, and ascites on MRI and ultrasonography (Figure 2).
Time course of clinical parameters in this patient. We continued 20 mg/day of furosemide and 25 g/day of spironolactone treatment for edema. He was treated with diet therapy of 1,600 kcal/day and a restriction of 6 g of salt after admission. In addition, we started 50 mg/day of fursultiamine hydrochloride. Plasma vitamin B1 concentration was increased from 20 to 853 ng/mL. His body weight was decreased by 18 kg only after two weeks and it was 83.2 kg at discharge. BW, body weight; BUN, blood urea nitrogen; AST, aspartate aminotransferase; ALT, alanine aminotransferase.
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In addition, ALT, AST, creatinine, and BUN were rather increased mildly probably due to dehydration 12 days after admission when body weight was decreased (Tables 1, 2; Figure 3). Thereafter, his liver and renal function were gradually improved (Figure 3).