A 59-year-old male presented to the emergency department for the evaluation of anasarca and foamy urine. The symptoms persisted for a week before he visited the emergency department. He was diagnosed with ankylosing spondylitis (AS) at the age of 25 and was treated with sulfasalazine and intermittent nonsteroidal anti-inflammatory drugs (NSAIDs). In addition, he had a history of well-controlled hypertension.
History of presenting illness The patient stated that he had experienced generalized fatigue, easy bruising, and a tingling sensation in his hands and feet. However, he denied any recent fever, orthostatic hypotension, chest pain, shortness of breath, abdominal pain, dysuria, or joint pain. His latest Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score was 9.28 , and Bath Ankylosing Spondylitis Functional Index (BASFI) score was 8.58 . Physical examination…
