case_images: PMC8714915_01
case_images: Total body CT: Chest CT showed a marginal pleural effusion and cardiomegaly. Abdominal CT revealed early liver cirrhosis together with fatty change, surface nodularity, and a small amount of ascites. Limb CT revealed severe subcutaneous edema mainly in the lower limb.
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case_images: PMC8714915_01_fnut-08-675992-g0001.jpg
case_images: F1
case_images: In addition, limb CT revealed severe subcutaneous edema mainly in the lower limb (Figure 1).
case_images: Magnetic resonance imaging (MRI) and ultrasonography showed lower limb edema.
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case_images: PMC8714915_01_fnut-08-675992-g0002.jpg
case_images: F2
case_images: It seemed that his effusion and edema were mainly due to lower limb edema and partially due to pleural effusion, cardiomegaly, and ascites on MRI and ultrasonography (Figure 2).
case_images: Time course of clinical parameters in this patient. We continued 20 mg/day of furosemide and 25 g/day of spironolactone treatment for edema. He was treated with diet therapy of 1,600 kcal/day and a restriction of 6 g of salt after admission. In addition, we started 50 mg/day of fursultiamine hydrochloride. Plasma vitamin B1 concentration was increased from 20 to 853 ng/mL. His body weight was decreased by 18 kg only after two weeks and it was 83.2 kg at discharge. BW, body weight; BUN, blood urea nitrogen; AST, aspartate aminotransferase; ALT, alanine aminotransferase.
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case_images: PMC8714915_01_fnut-08-675992-g0003.jpg
case_images: F3
case_images: In addition, ALT, AST, creatinine, and BUN were rather increased mildly probably due to dehydration 12 days after admission when body weight was decreased (Tables 1, 2; Figure 3). Thereafter, his liver and renal function were gradually improved (Figure 3).