Pedal edema causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: M.Umer Tariq [2]; Mugilan Poongkunran M.B.B.S

Overview

Pedal edema can be either pitting or non pitting. Peripheral pitting edema in which an indentation remains after pressure is released, is the more common type of peripheral edema, and results from water retention. It can be caused by systemic diseases, pregnancy in some women, heart failure, or local conditions such as varicose veins, thrombophlebitis, insect bites, and dermatitis. Non-pitting edema is observed when the indentation does not persist. It is associated with lymphedema, lipedema and myxedema. Edema caused by malnutrition defines kwashiorkor, an acute form of childhood protein-energy malnutrition characterized by edema, irritability, anorexia, ulcerating dermatoses, and an enlarged liver with fatty infiltrates.

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

• Anaphylaxis
• Bee sting
• Burns
• Carbon monoxide
• Crush syndrome
• Diabetic ketoacidosis
• Eclampsia
• Electric shock
• Gas gangrene
• Hereditary angioedema
• Malignant hyperthermia
• Metabolic poisons
• Mushroom poisoning
• Myocardial infarction

Common Causes

• Acute glomerulonephritis
• Calcium channel blockers
• Cellulitis
• Cirrhosis
• Congestive heart failure
• Deep vein thrombosis
• Diabetes
• Foot sprain
• Hormonal contraceptives
• Idiopathic
• Leg trauma
• Lymphedema
• Minoxidil
• Nephrotic syndrome

Causes by Organ System

Cardiovascular	Aneurysm, AV fistula, cardiac valvular dysplasia, cardiofaciocutaneous syndrome, cardiomyopathies, chronic constrictive pericarditis, chronic right sided heart failure, chronic venous insufficiency, congenital heart disease, congenital mitral malformation, congenital mitral stenosis, congestive heart failure, constrictive pericarditis, cor pulmonale, coronary heart disease, deep vein thrombosis, dilated cardiomyopathy, Henoch-Schönlein purpura, hereditary congenital lymphedema, hypertensive heart disease, infective endocarditis, left heart failure, left-sided valvular disease, lymphatic obstruction, lymphedema, lymphedema tarda, lymphedema-distichiasis syndrome, lymphoedema praecox, May-Thurner syndrome, Milroy's disease, myocardial Infarction, Noonan syndrome, Norgestrel and Ethinyl estradiol, pericardial effusion, pericarditis, peripheral vascular disease, phlegmasia alba dolens, portal hypertension, primary lymphedema, pulmonary stenosis, sub-pulmonary stenosis, thrombophlebitis, thrombosis, tricuspid regurgitation, tricuspid stenosis, varicose veins, vasculitis, venous obstruction, venous thrombosis, venous ulcer, yellow nail syndrome, Young Simpson syndrome
Chemical / poisoning	Carbon monoxide, bee sting, envenomation, insect bites, metabolic poisons, mushroom poisoning, snake venoms, snakebites, wasp
Dermatologic	Carbuncle, cellulitis, contact dermatitis, contusion, eosinophilic fasciitis, erysipelas, gas gangrene, Henoch-Schönlein purpura, Kawasaki disease, kerion, psoriatic arthritis, rocky mountain spotted fever, sarcoidosis, scleroderma
Drug Side Effect	Acetaminophen, ACE inhibitors, aceon, actos, aldomet, amiodarone, amlodipine, Amlodipine and Benazepril, Amlodipine besylate and Valsartan, amoxicillin-clavulanate, angiotensin II receptor blockers, antihistamines, arixtra, aspirin, atorvastatin, avandia, beta blockers,Bosutinib, calcium channel blockers, carbamazepine, carbenoxolone, cardura, casodex, Cefpodoxime, chlorpromazine, cilostazol, cisplatin, clopidogrel, colchicine, conivaptan, coreg, crestor, cyclophosphamide, dacarbazine, danazol, Denileukin diftitox, deserpidine, diltiazem, diflunisal, docetaxel, Enzalutamide, Eribulin, estrogen, Etonogestrel, evista, febuxostat, felodipine, flecainide, fludrocortisone, fondaparinux, gabapentin, Gemcitabine, glitazones, Goserelin, guanethidine, halothane, herceptin, hormonal contraceptives, hydralazine, Ibrutinib, ibuprofen, imatinib mesylate, indomethacin, intrathecal baclofen, isoniazid, isradipine, Ketorolac tromethamine, labetalol, lamotrigine, leflunomide, lipitor, lithium, malignant hyperthermia, Medroxyprogesterone, Megestrol, Meloxicam, methadone, methylprednisolone, methysergide, Mifepristone, minipress, minoxidil, miltefosine, Meprobamate, motrin, naltrexone, Naproxen sodium, Naproxen and esomeprazole magnesium, neuroleptic malignant syndrome, Niacin, nicardipine, nifedipine, nitrendipine, nitrofurantoin, non-depolarizing muscle blocking agents, nonsteroidal anti-inflammatory drugs, norpace, norvasc, Olanzapine, Olsalazine, Oprelvekin, phenylbutazone, phenytoin, pinacidil, pindolol, pioglitazone, Piroxicam, plendil, pramipexole, propylthiouracil, Radium chloride, Rasagiline, repaglinide, reserpine, riociguat,rofecoxib, ropinirole, roxithromycin, Sargramostim, saxagliptin, selective serotonin reuptake inhibitors, statins, Sunitinib, tamoxifen, taxol, tazarotene, temsirolimus, tenormin, thiazolidinedione, tocilizumab, Trametinib dimethyl sulfoxide, tretinoin, univasc, valproic acid, vasodilators, verapamil, vytorin, Thalidomide, xeloda, zidovudine, zonisamide
Ear Nose Throat	Alport syndrome
Endocrine	Acromegaly, Addison's disease, Cushing's syndrome, diabetes, diabetic ketoacidosis, hormonal contraceptives, hyperthyroidism, hypothyroidism, mitochondrial disease, myxoedema, ovarian hyperstimulation syndrome, POEMS syndrome, Young Simpson syndrome
Environmental	Bee sting, envenomation, frostbite, insect bites, mushroom poisoning, sunburn, wasp
Gastroenterologic	Alagille syndrome, alcohol abuse, alpha 1-antitrypsin deficiency, arginosuccinate synthetase deficiency, autoimmune hepatitis, biliary atresia, carcinoid tumours and carcinoid syndrome, celiac disease, cirrhosis, crohn's disease, exudative enteropathy, galactosemia, giardiasis, haemochromatosis, hemophagocytic lymphohistiocytosis, Hennekam syndrome, hepatic failure, hepatitis B virus, hepatitis C virus, hepatotoxicity, hereditary tyrosinemia type 1, hypertrophic gastritis, inflammatory bowel disease, intestinal lymphangiectasia, liver failure, malabsorption syndrome, milk protein allergy, Ménétrier's disease, non-alcoholic steatosis, portal hypertension, protein losing enteropathy, Wilson disease
Genetic	Alagille syndrome, alpha 1-antitrypsin deficiency, Alport syndrome, anti-glomerular basement membrane (anti-GBM) disease, arginosuccinate synthetase deficiency, biliary atresia, C1 esterase inhibitor (C1-INH) deficiency, cardiac valvular dysplasia, cardiofaciocutaneous syndrome, congenital heart disease, congenital mitral malformation, congenital mitral stenosis, cystic fibrosis, Dana syndrome, galactosemia, haemochromatosis, haemolytic disease of the newborn, hemophagocytic lymphohistiocytosis, Hennekam syndrome, Henoch-Schönlein purpura, hereditary angioedema, hereditary congenital lymphedema, hereditary fructose intolerance, hereditary tyrosinemia type 1, inherited hemolytic-uremic syndrome , lymphoedema-distichiasis syndrome, Milroy's disease, mitochondrial disease, Niemann-Pick disease, Noonan syndrome, ornithine transcarbamylase deficiency, POEMS syndrome, Turner syndrome, Young Simpson syndrome
Hematologic	Anemia, capillary leak syndrome, haemochromatosis, hemolytic disease of the newborn, hemophagocytic lymphohistiocytosis, hyperviscosity, hypoalbuminemia, Klippel Trenaunay Weber syndrome, microscopic polyangiitis, myeloproliferative disorders, POEMS syndrome, polycythemia, sickle cell disease, sickle cell trait
Iatrogenic	Bed rest, childbirth, coronary artery bypass surgery, fluid overload, psoralen plus ultraviolet A (PUVA) photochemotherapy, radiotherapy, surgery, surgical recovery, venous catheters
Infectious Disease	Acanthocheilonemiasis, cellulitis, chagas disease, chronic constrictive pericarditis, chronic hepatitis B, chronic hepatitis C, epidemic dropsy, falciparum malaria, gas gangrene, giardiasis, human immunodeficiency virus (HIV), infected cut, infective endocarditis, intestinal lymphangiectasia, lupus nephritis, lymphangitis carcinomatosa, lymphatic filariasis, osteomyelitis, post-streptococcal glomerulonephritis, rocky mountain spotted fever, septicemia, sleeping sickness (East African), sleeping sickness (West African), thrombophlebitis, trichinosis
Musculoskeletal / Ortho	Acromegaly, cardiofaciocutaneous syndrome, dermatomyositis, eosinophilic fasciitis, fracture, gas gangrene, gout, juvenile rheumatoid arthritis, Klippel Trenaunay Weber syndrome, Kohler disease, ligamentous sprain, metabolic myopathies, osteomyelitis, psoriatic arthritis, reflex sympathetic osteodystrophy, rheumatoid disease, rocky mountain spotted fever, rupture of popliteal cyst, systemic lupus erythematosus (SLE), Turner syndrome
Neurologic	Burning feet syndrome, carcinoid tumours and carcinoid syndrome, Dana syndrome, delirium tremens, eclampsia, grand mal seizures, Hennekam syndrome, mitochondrial disease, reflex sympathetic osteodystrophy
Nutritional / Metabolic	Acquired C1-esterase inhibitor deficiency, arginosuccinate synthetase deficiency, delirium tremens, galactosemia, gout, hereditary fructose intolerance, hypoalbuminemia, hypocalcemia, hypokalemia, hyponatremia, hypophosphatemia, kwashiorkor, malabsorption syndrome, malnutrition, metabolic myopathies, milk protein allergy, Niemann-Pick disease, ornithine transcarbamylase deficiency, protein losing enteropathy, refeeding edema, starvation edema, thiamine (Vitamin B1) deficiency, vitamin E deficiency
Obstetric/Gynecologic	Amniotic band syndrome, eclampsia, ovarian hyperstimulation syndrome, peripartum cardiomyopathy, preeclampsia, pregnancy, premenstrual syndrome
Oncologic	Carcinoid tumours and carcinoid syndrome, lymphangitis carcinomatosa, malignancies, myeloproliferative disorders
Opthalmologic	No underlying causes
Overdose / Toxicity	Amphetamine, cocaine, D-lysergic acid diethylamide (LSD), diazoxide, gold salts, heroin
Psychiatric	Anorexia nervosa, bulimia nervosa, burning feet syndrome, psychotic agitation, refeeding edema
Pulmonary	Alpha 1-Antitrypsin Deficiency, Alport syndrome, anti-glomerular basement membrane (anti-GBM) disease, cystic fibrosis, idiopathic pulmonary hypertension, pulmonary hypertension, pulmonary hypoxic hypertension, pulmonary thromboembolic hypertension, sarcoidosis, Wegener's granulomatosis, yellow nail syndrome
Renal / Electrolyte	Acute glomerulonephritis, acute renal failure, anti-glomerular basement membrane (anti-GBM) disease, Bartter's Syndrome, chronic renal failure, idiopathic minimal change nephrotic syndrome, IgG4–related systemic disease, immunoglobulinic amyloidosis, inherited hemolytic uremic syndrome, nephrotic syndrome, post-streptococcal glomerulonephritis, renal cell carcinoma, Wegener's granulomatosis
Rheum / Immune / Allergy	Acquired angioedema, acute phase reaction, anaphylaxis, autoimmune hepatitis, C1 esterase inhibitor (C1-INH) deficiency, cow milk protein sensitivity, dermatomyositis, eosinophilic fasciitis, hereditary angioedema, hypertrophic gastritis, IgG4–related systemic disease, inflammatory bowel disease, inherited hemolytic uremic syndrome, juvenile rheumatoid arthritis, Kawasaki disease, microscopic polyangiitis, Ménétrier's disease, rheumatoid disease, sarcoidosis, scleroderma, systemic lupus erythematosus (SLE), Wegener's granulomatosis
Sexual	Turner Syndrome
Trauma	Burns, crush syndrome, electric shock, foot sprain, foot ulcer, fracture of bone, infected cut, kerion, leg trauma
Urologic	No underlying causes
Miscellaneous	Air travel, alcohol abuse, burns, electric shock, exercise, idiopathic, immunoglobulinic amyloidosis, near drowning/hypothermia, obesity

Causes in Alphabetical Order

Acanthocheilonemiasis ACE inhibitor Aceon Acquired angioedema Acquired C1-esterase inhibitor deficiency Acromegaly Actos Acute glomerulonephritis Acute phase reaction Acute renal failure Addison's Disease Air travel Alagille syndrome Alcohol abuse Aldomet Alpha 1-antitrypsin deficiency Alport syndrome Amlodipine Amniotic band syndrome Amoxicillin-clavulanate Amphetamine Anaphylaxis Anemia Aneurysm Angiotensin II receptor blockers Anorexia nervosa Anti-glomerular basement membrane(anti-GBM) disease Antihistamines Arginosuccinate synthetase deficiency Aspirin Autoimmune hepatitis AV fistula Avandia Bartter's syndrome Bed rest Bee sting Beta blockers Biliary atresia Bulimia nervosa Burning feet syndrome Burns C1 esterase inhibitor (C1-INH) deficiency Calcium channel blockers Capillary leak syndrome Carbamazepine Carbenoxolone Carbon monoxide Carbuncle Carcinoid tumours and carcinoid syndrome Cardiac valvular dysplasia Cardiofaciocutaneous syndrome Cardiomyopathies Cardura Celiac disease Cellulitis Chagas disease Chemotherapy Childbirth Chronic constrictive pericarditis Chronic hepatitis B Chronic hepatitis C Chronic renal failure Chronic right sided heart failure Chronic venous insufficiency Cirrhosis Cisplatin Cocaine Colchicine Complex regional pain syndrome Congenital heart disease Congenital mitral malformation Congenital mitral stenosis Congestive heart failure Conivaptan Contact dermatitis Contusion Cor pulmonale Coronary artery bypass surgery Coronary heart disease Cow milk protein sensitivity Crohn's disease Crush syndrome Cushing's syndrome Cyclophosphamide Cystic fibrosis D-Lysergic acid diethylamide (LSD) Dacarbazine Dana syndrome Danazol Deep vein thrombosis Delirium tremens Dermatomyositis Deserpidine Diabetes Diabetic ketoacidosis Diazoxide Diltiazem Docetaxel Eclampsia Electric shock Envenomation Eosinophilic fasciitis Epidemic dropsy

Eribulin Erysipelas Estrogen dependent hereditary angioedema Estrogens Etonogestrel Exercise Exudative enteropathy Falciparum malaria Felodipine Fludrocortisone Fluid overload Foot sprain Foot ulcer Fracture of bone Frostbite Galactosemia Gas gangrene Giardiasis Glitazones Gold salts Gout Grand mal seizures Guanethidine Haemochromatosis Haemolytic disease of the newborn Halothane Hemophagocytic lymphohistiocytosis Hennekam syndrome Henoch-Schönlein purpura Hepatic failure Hepatotoxicity Hereditary angioedema Hereditary congenital lymphedema Hereditary fructose intolerance Hereditary tyrosinemia type 1 Heroin Hormonal contraceptives Human immunodeficiency virus (HIV) Hydralazine Hypertensive heart disease Hyperthyroidism Hypertrophic gastritis Hyperviscosity states Hypoalbuminemia Hypocalcemia Hypokalemia Hyponatremia Hypophosphatemia Hypothyroidism Hypothyroidism Ibuprophen Idiopathic Idiopathic minimal change nephrotic syndrome Idiopathic pulmonary hypertension IgG4 related systemic disease Imatinib mesylate Immobilization Immunoglobulinic amyloidosis Indomethacin Infected cut Infective endocarditis Inflammatory bowel disease Inherited hemolytic-uremic syndrome Insect bite Intestinal lymphangiectasia Intrathecal baclofen Isoniazid Isradipine Juvenile rheumatoid arthritis Kawasaki disease Kerion Klippel Trenaunay Weber syndrome Kohler disease Kwashiorkor Left heart failure Left-sided valvular disease Leg trauma Ligamentous sprain Lithium Lupus nephritis Lymphangitis Lymphangitis carcinomatosa Lymphatic filariasis Lymphatic obstruction Lymphedema Lymphedema tarda Malabsorption syndrome Malignancies Malignant hyperthermia Malnutrition May-Thurner syndrome Medroxyprogesterone Meloxicam Ménétrier's disease Metabolic myopathies Metabolic poisons Methadone Methysergide Microscopic polyangiitis Mifepristone Milk protein allergy Milroy's disease Minoxidil Mitochondrial disease Motrin Mushroom poisoning Myeloproliferative disorders Myocardial infarction

Myxoedema Near drowning/hypothermia Naproxen sodium Nephrotic syndrome Neuroleptic malignant syndrome Niacin Nicardipine Niemann-Pick disease Nifedipine Nitrendipine Nitrofurantoin Non-alcoholic steatosis Non-depolarizing muscle blocking agents Nonsteroidal anti-inflammatory drugs Noonan syndrome Norvasc Obesity Ornithine transcarbamylase deficiency Oprelvekin Osteomyelitis Ovarian hyperstimulation syndrome Palifermin Pelvic tumour Pericardial effusion Peripheral vascular disease Phenylbutazone Phenytoin Phlegmasia alba dolens Pinacidil Pioglitazone Piroxicam POEMS syndrome Polycythemia Portal hypertension Post-streptococcal glomerulonephritis Pramipexole Preeclampsia Pregnancy Premenstrual syndrome Primary lymphedema Lymphoedema praecox Lymphoedema-distichiasis syndrome Propylthiouracil Protein losing enteropathy Psoralen plus ultraviolet A (PUVA) photochemotherapy Psoriatic arthritis Psychotic agitation Pulmonary hypoxic hypertension Pulmonary stenosis Pulmonary thromboembolic hypertension Radiotherapy Radium chloride Refeeding edema Reflex sympathetic osteodystrophy Renal cell carcinoma Reserpine Rheumatoid disease Riociguat Rocky mountain spotted fever Rofecoxib Ropinirole Roxithromycin Rupture of popliteal cyst Sarcoidosis Sargramostim Scleroderma Selective serotonin reuptake inhibitors Septicemia Sickle cell disease Sickle cell trait Sleeping sickness (East African) Sleeping sickness (West African) Snake venoms Snakebites Starvation Statins Sub-pulmonary stenosis Sunburn Sunitinib Surgery Surgical recovery Systemic lupus erythematosus (SLE) Temsirolimus Thiamine (Vitamin B1) deficiency Thiazolidinedione Thrombophlebitis Thrombosis Trametinib dimethyl sulfoxide Tretinoin Trichinosis Tricuspid regurgitation Tricuspid stenosis Turner syndrome Univasc Valproic acid Varicose veins Vasculitis Vasodilators Venous catheters Venous insufficiency Venous obstruction Venous thrombosis Venous ulcer Vitamin E deficiency Vytorin Wasp Wegener's granulomatosis Wilson disease Yellow nail syndrome Young Simpson syndrome Zidovudine