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Previous Volume 337:1377-1381 November 6, 1997 Number 19 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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A 48-year-old man who had received three cadaveric renal transplants had a 10-day history of painless edema of the legs. He was not short of breath at rest but had had moderate dyspnea on exertion for a week.

The edema may be hydrostatic in origin, from either heart failure or other causes, or oncotic in origin, from hypoalbuminemia; bilateral deep venous thromboses would be unusual. The patient's shortness of breath may be caused by heart failure or fluid overload, but it could indicate lung infection. He is immunocompromised, so we need a broad differential diagnosis that includes opportunistic infection as . . . [Full Text of this Article]

Commentary

Source Information

From the Veterans Affairs Medical Center, White River Junction, Vt. (J.D.L.), and the Department of Medicine, Dartmouth–Hitchcock Medical Center, Lebanon, N.H. (J.D.L., H.C.S.).

Address reprint requests to Dr. Lurie at Outcomes Group (111B), Veterans Affairs Medical Center, White River Junction, VT 05009.

References

Related Letters:

Clinical Problem-Solving: High on the Differential
Gossmann J., Koehler U. H., Lurie J. D., Sox H. C.
Extract | Full Text  
N Engl J Med 1998; 338:767-769, Mar 12, 1998. Correspondence

This article has been cited by other articles:

• Hung, S.-C., Hung, S.-H., Yang, W.-C., Tarng, D.-C. (2003). Dialysis-resistant pulmonary oedema. Nephrol Dial Transplant 18: 1406-1409 [Full Text]  
• Gossmann, J., Koehler, U. H., Lurie, J. D., Sox, H. C. (1998). Clinical Problem-Solving: High on the Differential. NEJM 338: 767-769 [Full Text]