Edema: Difference between revisions
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==Etiology/cause== | ==Etiology/cause== | ||
* Hydrostatic due to [[heart failure]] or [[venous insufficiency]]. | * Hydrostatic edema due to [[heart failure]] or [[venous insufficiency]]. | ||
* [[ | * Hypoprotenemic edema due to nephrotic syndrome, [[cirrhosis]], [[protein-energy malnutrition]] (including [[Kwashiorkor]] and [[marasmus]]) | ||
* Capillary lead edema including idiopathic edema | |||
* [[Acute kidney injury]] or [[chronic kidney disease]] | * [[Acute kidney injury]] or [[chronic kidney disease]] | ||
* [[Medication]]s such as [[vasodilator agent]]s used for [[hypertension]] may cause edema by stimulating sodium reabsorption. | * [[Medication]]s such as [[vasodilator agent]]s used for [[hypertension]] may cause edema by stimulating sodium reabsorption. | ||
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==Diagnosis== | ==Diagnosis== | ||
Although edema is frequently attributed to [[venous insufficiency]], whereas [[pulmonary hypertension]] possibly due to sleep apnea may be at least as common.<ref name="pmid9753021">{{cite journal |author=Blankfield RP, Finkelhor RS, Alexander JJ, ''et al'' |title=Etiology and diagnosis of bilateral leg edema in primary care |journal=The American journal of medicine |volume=105 |issue=3 |pages=192–7 |year=1998 |month=September |pmid=9753021 |doi=10.1016/S0002-9343(98)00235-6 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9343(98)00235-6 |issn=}}</ref> | |||
===Physical examination=== | ===Physical examination=== | ||
On [[physical examination]], fast recovery of pitting is associated with lower serum [[albumin]] levels.<ref name="pmid638510">{{cite journal |author=Henry JA, Altmann P |title=Assessment of hypoproteinaemic oedema: a simple physical sign |journal=British medical journal |volume=1 |issue=6117 |pages=890–1 |year=1978 |month=April |pmid=638510 |pmc=1603695 |doi= |url= |issn=}}</ref> Fast recovery within 2-3 seconds, is more sensitive than specific at detecting hypoalbuminemia. Presumably this is related to the viscosity of the interstitial fluid thus hypoalbuminemic interstitial fluid can reform more quickly.<ref name="pmid638510"/> | On [[physical examination]], fast recovery of pitting is associated with lower serum [[albumin]] levels.<ref name="pmid638510">{{cite journal |author=Henry JA, Altmann P |title=Assessment of hypoproteinaemic oedema: a simple physical sign |journal=British medical journal |volume=1 |issue=6117 |pages=890–1 |year=1978 |month=April |pmid=638510 |pmc=1603695 |doi= |url= |issn=}} [http://www.pubmedcentral.nih.gov/articlerender.fcgi?pubmedid=638510 PubMed Central]</ref> Fast recovery within 2-3 seconds, is more sensitive than specific at detecting hypoalbuminemia. Presumably this is related to the viscosity of the interstitial fluid thus hypoalbuminemic interstitial fluid can reform more quickly.<ref name="pmid638510"/> | ||
==References== | ==References== | ||
<references/> | <references/> | ||
Revision as of 06:11, 3 November 2008
In medicine, edema is "abnormal fluid accumulation in tissues or body cavities. Most cases of edema are present under the skin in subcutaneous tissue."[1][2][2][3]
Similar terms are:
- Angioedema is "swelling involving the deep dermis, subcutaneous, or submucosal tissues, representing localized edema. Angioedema often occurs in the face, lips, tongue, and larynx."[4]
- Lymphedema is "edema due to obstruction of lymph vessels or disorders of the lymph nodes.[5]
- Myxedema is a "condition characterized by a dry, waxy type of swelling (edema) with abnormal deposits of mucopolysaccharides in the skin and other tissues. It is caused by a deficiency of thyroid hormones. The skin becomes puffy around the eyes and on the cheeks. The face is dull and expressionless with thickened nose and lips."[6]
Extreme cases of edema are called anasarca.
Classification
- Diffuse edema, more commonly called peripheral edema or dependent edema.
- Focal edema from angiodema.
Etiology/cause
- Hydrostatic edema due to heart failure or venous insufficiency.
- Hypoprotenemic edema due to nephrotic syndrome, cirrhosis, protein-energy malnutrition (including Kwashiorkor and marasmus)
- Capillary lead edema including idiopathic edema
- Acute kidney injury or chronic kidney disease
- Medications such as vasodilator agents used for hypertension may cause edema by stimulating sodium reabsorption.
- Obesity may by associated with both lymphedema and edema. 75% of morbidly obese patients (body mass index >40) may have lymphedema.[7] Obesity may be associated with edema due to obstructive sleep apnea and secondary pulmonary hypertension.[8][9]
Diagnosis
Although edema is frequently attributed to venous insufficiency, whereas pulmonary hypertension possibly due to sleep apnea may be at least as common.[10]
Physical examination
On physical examination, fast recovery of pitting is associated with lower serum albumin levels.[11] Fast recovery within 2-3 seconds, is more sensitive than specific at detecting hypoalbuminemia. Presumably this is related to the viscosity of the interstitial fluid thus hypoalbuminemic interstitial fluid can reform more quickly.[11]
References
- ↑ Anonymous (2024), Edema (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ 2.0 2.1 Little RC, Ginsburg JM (August 1984). "The physiologic basis for clinical edema". Archives of internal medicine 144 (8): 1661–4. PMID 6466021. [e]
- ↑ Cho S, Atwood JE (November 2002). "Peripheral edema". The American journal of medicine 113 (7): 580–6. DOI:10.1016/S0002-9343(02)01322-0. PMID 12459405. Research Blogging.
- ↑ Anonymous (2024), Angioedema (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ Anonymous (2024), Lymphedema (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ Anonymous (2024), Myxedema (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ Fife CE, Carter MJ (January 2008). "Lymphedema in the morbidly obese patient: unique challenges in a unique population". Ostomy/wound management 54 (1): 44–56. PMID 18250486. [e]
- ↑ Blankfield RP, Hudgel DW, Tapolyai AA, Zyzanski SJ (2000). "Bilateral leg edema, obesity, pulmonary hypertension, and obstructive sleep apnea". Archives of internal medicine 160 (15): 2357–62. PMID 10927734. [e]
- ↑ Blankfield RP, Zyzanski SJ (June 2002). "Bilateral leg edema, pulmonary hypertension, and obstructive sleep apnea: a cross-sectional study". The Journal of family practice 51 (6): 561–4. PMID 12100781. [e]
- ↑ Blankfield RP, Finkelhor RS, Alexander JJ, et al (September 1998). "Etiology and diagnosis of bilateral leg edema in primary care". The American journal of medicine 105 (3): 192–7. DOI:10.1016/S0002-9343(98)00235-6. PMID 9753021. Research Blogging.
- ↑ 11.0 11.1 Henry JA, Altmann P (April 1978). "Assessment of hypoproteinaemic oedema: a simple physical sign". British medical journal 1 (6117): 890–1. PMID 638510. PMC 1603695. [e] PubMed Central