43M DM, Calcific Pancreatitis Telangana PaJR

 

13-06-2025

THIS IS AN ONLINE E LOG BOOK TO DISCUSS OUR PATIENT'S DE-IDENTIFIED HEALTH DATA SHARED AFTER TAKING HIS SIGNED INFORMED CONSENT. HERE WE DISCUSS OUR PATIENT'S PROBLEMS THROUGH SERIES OF INPUTS FROM AVAILABLE GLOBAL ONLINE COMMUNITY EXPERTS WITH AN AIM TO SOLVE THOSE PATIENT'S CLINICAL PROBLEMS WITH COLLECTIVE CURRENT BEST EVIDENCE BASED INPUTS.

[13-06-2025 11.57] PPM 1: OPD 43M

Calcific pancreatitis and type 3 Diabetes with osmotic symptoms since 10 months @PPM2

Alcohol consumption as in 10 bottles continuously for 10 days with large gaps of months to years. Was diagnosed 1 year back here with calcific pancreatitis 

Currently complains of severe muscle pains and on examination (attached images) suggestive of sarcopenia along with left biceps Popeye.

23M Nephrotic Syn, 18yrs, Cushings, Diabetes, Hypothyroidism Telangana PaJR

 

12-06-2025

THIS IS AN ONLINE E LOG BOOK TO DISCUSS OUR PATIENT'S DE-IDENTIFIED HEALTH DATA SHARED AFTER TAKING HIS SIGNED INFORMED CONSENT. HERE WE DISCUSS OUR PATIENT'S PROBLEMS THROUGH SERIES OF INPUTS FROM AVAILABLE GLOBAL ONLINE COMMUNITY EXPERTS WITH AN AIM TO SOLVE THOSE PATIENT'S CLINICAL PROBLEMS WITH COLLECTIVE CURRENT BEST EVIDENCE BASED INPUTS.

BRIEF HISTORY

23 year old male admitted in SICU

For right lower limb cellulitis with ? Necrotising fascitis 

At the age of 5-6years

 patient had anuria with anasarca and was 

Diagnosed to have nephrotic syndrome 

Initially was started on steroids

Later diagnosed as steroid resistant nephrotic syndrome biopsy -FSGS (2014)

Was treated with Iv rituximab 2doses

Followed by Azathiaprine 2014 to 2017

2017 -Started on Calcineurin inhibitors - tacrolimus

Had complete remission from 2017 to 2021

1/20 - on complete remission with tacrolimus treatment.

2 /21 -Tacrolimus stopped to due to 

? Tacrolimus induced uncontrolled sugars

Followed by relapse

10/21 - 2nd dosage of IV rituximab 2doses given 

Irregular follow-up and no consultation for 3years.

During these years was on tacrolimus 0.5mg

Telmisartan 20mg atorvastatin 20mg

And metformin 500mg bd

Also diagnosed with hypothyroidism and is on thyronorm 12.5mcg

12/2024- went for follow up again 

With c/o bilateral pedal odema

Was started on tab prednisolone 40mg and tab.Mycophenolate Moefitil 360mg now on Prednisolone 10mg weekly once (Mycophenolate stopped 3- 4months back).