Case Presentation: A 54-year-old male with a history of obesity, asthma, alcohol use disorder, tobacco use disorder, and hepatic steatosis presented with anasarca. Transthoracic echocardiogram did not demonstrate evidence of heart failure, urinalysis revealed trace proteinuria, and liver ultrasound showed patent vasculature. Albumin was 2.5. The anasarca persisted despite diuresis. Over the next two months, [...]