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Reminder of important clinical lesson
CASE REPORT
A rare cause of ascites in a renal transplant recipient
  1. Ganesh Kasinadhuni1,
  2. Jasmine Sethi2,
  3. Darshan Krishnappa1,
  4. Yash Paul Sharma1
  1. 1Department of Cardiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
  2. 2Department of Nephrology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
  1. Correspondence to Dr Yash Paul Sharma, ypspgi{at}gmail.com

Summary

Thirty-five-year-old man, underwent renal transplantation 4 years back and was doing well. He now presented with complaints of ascites with engorged neck veins and dyspnoea on exertion for last 6 months. Examination showed elevated jugular venous pressure with two prominent descents, high pitched diastolic heart sound (pericardial knock). Echocardiography showed characteristic features of thickened pericardium, septal bounce, expiratory flow reversal in hepatic veins and phasic variation of mitral inflow, suggestive of constrictive pericarditis. The patient was started on empirical antitubercular therapy and diuretics. The patient symptomatically improved, but in view of persisting constrictive physiology he was planned for pericardiectomy.

  • pericardial disease
  • tb and other respiratory infections
  • renal transplantation
  • tuberculosis

https://doi.org/10.1136/bcr-2018-226532

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    Footnotes

    • Contributors GNK, DK and JS: concept and design, drafting manuscript. YPS: final editing and approval. All the authors have contributed equally and are accountable.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.