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Sleeplessness Accompanied By Puffy Veins, Edema Back Heels, High Triglyceride And Increased Hepatic Echogenicity

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Posted on Wed, 13 Jun 2012
Question: An ultrasound abdomen and pelvic exam was given two weeks ago: 61 years/5'10"/230 lbs. I take 40 mg Statin for Triglycerides/plaque daily and my body, but mostly my legs (puffy veins), edema back heel and both feet and toes hurt. I find it difficult to sleep until mid-night and arise at 6 AM, legs and body have pain most days/nights, for several years now.
Exam revealed 18.5 cm liver w/tip extending beyond lower pole of right kidney. Hepatic echogenicity increased w/questionable posterior acoustical shadowing, w/common bile duct 0.7 cm diameter, w/all other normal. Kidneys normal w/mild left pelviectasis, not previously present. No caliectasis, and aorta is normal. No abdominal masses or fluids identified.
Should I get more testing? Thank You Doctor!
doctor
Answered by Dr. Poorna Chandra K.S (1 hour later)
Hi and thanks for the query

By your history I understand that you have myalgia and edema of legs and on investigations you have a high triglyceride ( could not get the meaning of plaque) and fatty liver on an Ultrasound.
Statins are used for elevated LDL cholestrol and can cause myalgias and elevated liver enzymes as an adverse effect. However they have minimal effect on the triglycerides
Further in a female of your age defeciency of vitamin D3 is common and it can cause myalgias
Edema feet are usually secondary to either -
1) varicose veins and XXXXXXX vein thrombosis of leg ( do you mean this by puffy veins)
2) Kidney probmens - nephrotic syndrome (protein losing) or renal failure
3) Liver problems like cirrhosis whin can be the final stage of untreated fatty liver
4)Cardiac failure
5) Hypothyroidism
To differentiate between these we need to have tests kike liver function test, renal function test, fasting TSH, hemogram, 24 hr urine protein estimation, calcium profile including vit D3,fasting blood sugars and a lipidogram and doppler ultrasound of the lower limb

Hope I have answered your query. If you have any follow up queries I will be available to answer them.

Regards
Dr XXXXXXX
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Above answer was peer-reviewed by : Dr. Raju A.T
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Answered by
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Dr. Poorna Chandra K.S

Gastroenterologist

Practicing since :2000

Answered : 339 Questions

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Sleeplessness Accompanied By Puffy Veins, Edema Back Heels, High Triglyceride And Increased Hepatic Echogenicity

Hi and thanks for the query

By your history I understand that you have myalgia and edema of legs and on investigations you have a high triglyceride ( could not get the meaning of plaque) and fatty liver on an Ultrasound.
Statins are used for elevated LDL cholestrol and can cause myalgias and elevated liver enzymes as an adverse effect. However they have minimal effect on the triglycerides
Further in a female of your age defeciency of vitamin D3 is common and it can cause myalgias
Edema feet are usually secondary to either -
1) varicose veins and XXXXXXX vein thrombosis of leg ( do you mean this by puffy veins)
2) Kidney probmens - nephrotic syndrome (protein losing) or renal failure
3) Liver problems like cirrhosis whin can be the final stage of untreated fatty liver
4)Cardiac failure
5) Hypothyroidism
To differentiate between these we need to have tests kike liver function test, renal function test, fasting TSH, hemogram, 24 hr urine protein estimation, calcium profile including vit D3,fasting blood sugars and a lipidogram and doppler ultrasound of the lower limb

Hope I have answered your query. If you have any follow up queries I will be available to answer them.

Regards
Dr XXXXXXX