3rd April 2024

A 37 year old female presents to the clinic with a 2 week history of bilateral ankle swelling.

A 37 year old female presents to the clinic with a 2 week history of bilateral ankle swelling. She states that she has had longstanding fatigue and altered bowels. She exercises regularly and has a good appetite. She has a background of type 1 diabetes, frozen shoulder and has been taking the combined oral contraceptive pill (COCP) for the last month. On questioning, she states her grandfather died of bowel cancer. Her BMI is 17 kg/m² and routine blood tests show a low albumin of 25 g/L (normal range 35 – 50). Which of the following is the cause of her ankle swelling?

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