Case of a 47 years old female with weight loss.



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This is the case of a 47 years old housewife, resident of West Bengal.

CHIEF COMPLAINT

The patient presented with the  chief complaint of weight loss since 1 year.

HISTORY OF PRESENTING ILLNESS

The patient was apparently asymptomatic 1 year ago , when she developed an abscess in the posterior aspect of her right thigh , that was insidious onset , progressive ( initially being about 1cm , progressing to about 3-4 inches ), with redness and hardening of the surrounding skin and local rise of temperature over the swelling .It was associated with pain ,insidious in onset, that was dragging type in character , progressive , non radiating , with no aggravating factors , but relieved on taking medications .Also associated with low grade fever, without chills and rigors, that lasted for 4-6 days after the abscess appeared .

10 days later -Due to the swelling progressing in size ,the patient went to the doctor .Incision and drainage of the pus was performed . The patient was prescribed antibiotics and ointment , that the patient used for 1 month .Following the hospital visit the patient’s husband would drain the abscess twice a day for 15 days at home.The abscess healed after a month and the patient complains of the area being hard since then . 

During the course of treatment, the patient's family started noticing a reduction in her weight. Over a period of 1 year, the patient lost at least 12kg of weight, from 75 kgs initially to 63 kgs. Not  associated with decreased appetite . The patient has been unable to gain any weight even after trying to gain weight .The patient complains of loss of lustre of the skin and dryness ,and having a dull appearance .

The patient also complains of hair fall and dryness of hair ,since 1 year that reduced on taking medication ( multivitamins and iron supplements ).

The patient also complains of irregular menstrual cycles since 1 year .

The patient also complains of dark spots and redness on face ,that aggravates on exposure to sun and have become more prominent since 1 year . 




HISTORY OF PAST ILLNESS

Known case of hypertension since 6 months.

Not a known case of DM, asthma, TB, Thyroid condition, CVD, or Epilepsy.

History of gall stone removal at the age of 17 years old .

MENSTRUAL HISTORY

MENARCHE -14 years

Irregular ,heavy flow ,that lasts for 3 days since 1 year

Associated with pain and clots

FAMILY HISTORY

Mother and father - Known cases of DM and hypertension 

Sisters - Known case of hypertension 

No history of cancer .

PERSONAL HISTORY

DIET- Non vegetarian 

APPETITE- Normal 

SLEEP- Normal 

BOWEL AND BLADDER MOVEMENTS - 

Bowel movements - Regular 

Bladder - Normal 

ADDICTIONS- None 

ALLERGIES- Dust and pollen  


INVESTIGATIONS 

27/4/2022



CLINICAL IMAGES 





27/7/23
Weight - 60 kgs 
Blood pressure - 120/80 mmHg





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