A 58-year-old woman is presented to the clinic in a wheelchair by her husband. She reports progressive skin tightening and a palpable “ woody feeling ” in the lower extremities, leading to decreased ambulation. She has a medical history of osteomyelitis and diabetic chronic kidney disease while receiving haemodialysis and was hospitalized 6 months previously for a minor stroke from which she has completely recovered.
Vital signs are WNL and her extremities appear woody and sclerotic, with nonpitting swelling in both lower extremities. Medications: Darbepoetin, 60 μg subcutaneously monthly, Pioglitazone, 15 mg/d orally, Furosemide, 60 mg/d orally, Aspirin, 81 mg/d orally Laboratory Results: Sodium, 140 mEq/L, Potassium, 4.0 mmol/L, Hemoglobin, 10.5 g/dL, Creatinine, 2.0 mg/dL Please suggest management for this case. *This case is from Docplexus Editorial Team for educative purpose…
