57-Year-Old Woman With Fatigue and Dyspnea

• Published in: Mayo Clinic proceedings Vol. 95; no. 12; pp. 2755 - 2759
• Main Authors: Hazim, Antonious Z., Ruan, Gordon J., Issa, Meltiady
• Format: Journal Article
• Language: English
• Published: England Elsevier Inc 01.12.2020; Elsevier, Inc; Frontline Medical Communications Inc; Elsevier Limited
• Subjects: Abdomen; Acute Kidney Injury - diagnosis; Acute Kidney Injury - etiology; Acute Kidney Injury - physiopathology; Acute Kidney Injury - therapy; Amyloidosis - complications; Amyloidosis - diagnosis; Amyloidosis - physiopathology; Biopsy; Blood pressure; Bone Marrow Examination - methods; Care and treatment; Case studies; Chemotherapy; Complications and side effects; Congestive heart failure; Creatinine; Development and progression; Diabetes; Diagnosis, Differential; Diarrhea; Dietary intake; Dyspnea; Dyspnea - diagnosis; Dyspnea - etiology; Echocardiography - methods; Edema; Electrocardiography; Emergency medical care; Etiology; Fatigue; Fatigue - diagnosis; Fatigue - etiology; Female; Furosemide; Heart failure; Hematuria; Humans; Hypertension; Immunoglobulin Light Chains - analysis; Immunoglobulins; Infections; Kidney - diagnostic imaging; Kidney - pathology; Kidney diseases; Kidney Function Tests - methods; Kidneys; Light; Middle Aged; Multiple myeloma; Multiple Myeloma - blood; Multiple Myeloma - complications; Multiple Myeloma - diagnosis; Multiple Myeloma - physiopathology; Patient Care Management; Patients; Plasma; Prognosis; Proteins; Radiation therapy; Radiography; Renal Dialysis - methods; Respiration; Shortness of breath; Stem cells; Thrombosis; Veins & arteries; Weight loss; United States
• ISSN: 0025-6196; 1942-5546
• DOI: 10.1016/j.mayocp.2020.04.053

A 57-year-old woman presented to the emergency department with progressive fatigue, oliguria, and dyspnea. Three weeks before presentation, she experienced worsening fatigue and shortness of breath. Her symptoms were associated with watery diarrhea and poor dietary intake. She also reported weight loss and decreased urinary output with no gross hematuria. Her medical history was notable for systolic heart failure of unclear etiology and unknown duration with an ejection fraction of 37% and essential hypertension. Medications included lisinopril and furosemide. She was a former smoker. Her family history was unremarkable.