My sister has edema, moon face, and proximal myopathy. Why?

Question

Hi doctor,

My sister is 37 years old with previous 2 LSCS. She has symptoms such as swelling over whole body and face. Along with these complaints she has weakness, tiredness, cushingoid facies, proximal myopathy, palpitation, trembling of hands and amenorrhea or slight on and off spotting. She is suffering with recurrent nephrotic syndrome since 3 years. Currently she is on Tacrolimus 2.5 mg in the morning, 2 mg in the evening, Omnacortil 30 mg and Telmisartan 40 mg each once a day, Atorvastatin once at night and Calciferol twice a day weekly. I am attaching all her reports for your reference. Kindly check them and help us out. Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I checked your sister's complete details (attachments removed to protect patient identity).

She is suffering from relapsing nephrotic syndrome. Her cushingoid facies and proximal myopathy are steroid induced as you must be already knowing.
Gradually replacing the steroids with other immunosuppressive agents is the treatment of choice and the preferred ones are Endoxan (Cyclophosphamide) as well as Tacrolimus.
I suppose, her treatment is in the right direction and what I can add here is monoclonal antibody Rituximab, that is Anti-CD20 and targets on B cells of your body. This drug is going to give you remission. You should discuss with your treating doctor to add up this drug for you.

- For further queries consult a nephrologist online.