Edema
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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]
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."[3]
- Lymphedema is "edema due to obstruction of lymph vessels or disorders of the lymph nodes.[4]
- 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."[5]
Extreme cases of edema are called anasarca.
Etiology/cause
- Hydrostatic due to heart failure or venous insufficiency.
- Cirrhosis
- Protein-energy malnutrition including Kwashiorkor and marasmus
- 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.[6] Obesity may be associated with edema due to obstructive sleep apnea and secondary pulmonary hypertension.[7][8]
Diagnosis
Physical examination
On physical examination, fast recovery of pitting is associated with lower serum albumin levels.[9] 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.[9]
References
- ↑ Anonymous (2024), Edema (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ Little RC, Ginsburg JM (August 1984). "The physiologic basis for clinical edema". Archives of internal medicine 144 (8): 1661–4. PMID 6466021. [e]
- ↑ 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]
- ↑ 9.0 9.1 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]