Dr. Ajeet Singh (General Practice) needs a second opinion on this medical case.
A 45 year old female housewife by occupation
Pain in legs
Brown coloured urine
Decreased urine output than before
She is experiencing these symptoms for past 5 days and she has stopped all her RA drugs too
Known case of HTN with CKD with RA with Hyperuricemia
She was on -
Methotrexate 7.5 weekly
HCQ 200mg BD
Folic Acid 5mg OD
She stopped all these drugs thinking of drugs being cause of urine colour change and infection
Ordered investigations -
S Urea, S Cr
S Uric Acid
My concerns -
1) Safest anti hypertensives that can be given in this case of hyperuricemia with CKD with RA ?
2) Is any drug of RA a culprit for her urinary tract problem that she is facing?
3) Can't sulphasalazine could be given before thinking about HCQ or Leflulonamide?