Edema: Difference between revisions
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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."<ref>{{MeSH}}</ref><ref name="pmid6466021">{{cite journal |author=Little RC, Ginsburg JM |title=The physiologic basis for clinical edema |journal=Archives of internal medicine |volume=144 |issue=8 |pages=1661–4 |year=1984 |month=August |pmid=6466021 |doi= |url= |issn=}}</ref> | |||
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 [[Laryngeal edema|larynx]]."<ref>{{MeSH|Angioedema}}</ref> | |||
* Lymphedema is "edema due to obstruction of lymph vessels or disorders of the lymph nodes.<ref>{{MeSH|Lymphedema }}</ref> | |||
* 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."<ref>{{MeSH|Myxedema}}</ref> | |||
Extreme cases of edema are called anasarca. | |||
==Etiology/cause== | ==Etiology/cause== | ||
* Hydrostatic due to [[heart failure]] or [[venous insufficiency]]. | * Hydrostatic due to [[heart failure]] or [[venous insufficiency]]. | ||
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* [[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. | ||
* [[Obesity]] may by associated with both lymphedema and edema. 75% of morbidly obese patients ([[body mass index]] >40) may have lymphedema.<ref name="pmid18250486">{{cite journal |author=Fife CE, Carter MJ |title=Lymphedema in the morbidly obese patient: unique challenges in a unique population |journal=Ostomy/wound management |volume=54 |issue=1 |pages=44–56 |year=2008 |month=January |pmid=18250486 |doi= |url= |issn=}}</ref> Obesity may be associated with edema due to obstructive sleep apnea and secondary [[pulmonary hypertension]].<ref name="pmid10927734">{{cite journal |author=Blankfield RP, Hudgel DW, Tapolyai AA, Zyzanski SJ |title=Bilateral leg edema, obesity, pulmonary hypertension, and obstructive sleep apnea |journal=Archives of internal medicine |volume=160 |issue=15 |pages=2357–62 |year=2000 |pmid=10927734 |doi= |url=http://archinte.ama-assn.org/cgi/pmidlookup?view=long&pmid=10927734 |issn=}}</ref><ref name="pmid12100781">{{cite journal |author=Blankfield RP, Zyzanski SJ |title=Bilateral leg edema, pulmonary hypertension, and obstructive sleep apnea: a cross-sectional study |journal=The Journal of family practice |volume=51 |issue=6 |pages=561–4 |year=2002 |month=June |pmid=12100781 |doi= |url=http://www.jfponline.com/Pages.asp?AID=1211 |issn=}}</ref> | * [[Obesity]] may by associated with both lymphedema and edema. 75% of morbidly obese patients ([[body mass index]] >40) may have lymphedema.<ref name="pmid18250486">{{cite journal |author=Fife CE, Carter MJ |title=Lymphedema in the morbidly obese patient: unique challenges in a unique population |journal=Ostomy/wound management |volume=54 |issue=1 |pages=44–56 |year=2008 |month=January |pmid=18250486 |doi= |url= |issn=}}</ref> Obesity may be associated with edema due to obstructive sleep apnea and secondary [[pulmonary hypertension]].<ref name="pmid10927734">{{cite journal |author=Blankfield RP, Hudgel DW, Tapolyai AA, Zyzanski SJ |title=Bilateral leg edema, obesity, pulmonary hypertension, and obstructive sleep apnea |journal=Archives of internal medicine |volume=160 |issue=15 |pages=2357–62 |year=2000 |pmid=10927734 |doi= |url=http://archinte.ama-assn.org/cgi/pmidlookup?view=long&pmid=10927734 |issn=}}</ref><ref name="pmid12100781">{{cite journal |author=Blankfield RP, Zyzanski SJ |title=Bilateral leg edema, pulmonary hypertension, and obstructive sleep apnea: a cross-sectional study |journal=The Journal of family practice |volume=51 |issue=6 |pages=561–4 |year=2002 |month=June |pmid=12100781 |doi= |url=http://www.jfponline.com/Pages.asp?AID=1211 |issn=}}</ref> | ||
==Diagnosis== | |||
===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"/> | |||
==References== | |||
<references/> | |||
Revision as of 06:52, 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]
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]