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Postgrad Med J 2001;77:529-530 doi:10.1136/pmj.77.910.529
  • Self assessment questions

Generalised oedema, lethargy, personality disturbance, and recurring nightmares in a young girl

  1. N D Hawkesa,
  2. D Mutimerb,
  3. G A O Thomasa
  1. aDepartment of Gastroenterology, University Hospital of Wales, Cardiff, UK, bLiver Unit, Queen Elizabeth Hospital, Birmingham, UK
  1. Dr Neil Hawkes, Department of Gastroenterology, Ward A7, University Hospital of Wales, Heath Park, Cardiff CF14 4XN, UKneilhawkes{at}doctors.org.uk
  • Received 1 November 2000
  • Accepted 2 March 2001

Answers on p 537.

A 17 year old girl presented with a six week history of loose, yellow motions, marked leg swelling, increased shortness of breath, lethargy, and decreased exercise tolerance. She had gained 10 kg in weight in four months. Her mother commented that over the past nine months she had been somewhat depressed and withdrawn and had suffered from recurring nightmares.

Six weeks before admission, she had complained of left sided abdominal discomfort, polyuria, and haematuria and was …

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