27th June 2023

A 38-year-old woman with a background of alcohol excess and rheumatoid arthritis presents with two years of burning pain and peripheral neuropathy

A 38-year-old woman with a background of alcohol excess and rheumatoid arthritis presents with two years of burning pain and peripheral neuropathy in her hands and feet. On examination, she appears fluid overloaded and has hepatomegaly. There is +++ protein in her urine. Bloods show borderline low haemoglobin, raised MCV, low platelets, raised urea, and slightly raised creatinine. Chest X-ray is unremarkable

Select the SINGLE most appropriate cause of the symptoms from the list below. Select ONE option only.