Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1], Associate Editor(s)-in-Chief: Martin Nino, M.D. [2]
Synonyms and keywords: oedema or œdema
Overview
Edema (American English), formerly known as dropsy or hydropsy, is the increase of interstitial fluid in any organ — swelling. Generally, the amount of interstitial fluid is in the balance of homeostasis. Increased secretion of fluid into the interstitium or impaired removal of this fluid may cause edema. Cutaneous edema is referred to as "pitting" when, after pressure is applied to a small area, the indentation persists after the release of the pressure.
Classification
Edema can be classified into pitting edema and non piting edema. Peripheral pitting edema is the more common type, resulting from water retention. It can be caused by systemic diseases, pregnancy in some women, either directly or as a result of 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 such conditions as lymphedema, lipedema, and myxedema.
Pathophysiology
Generation of interstitial fluid is regulated by the Starling equation of tissue fluid which states that it depends on the balance of osmotic pressure and of hydrostatic pressure which act in opposite directions across the semipermeable capillary walls. Consequently, anything that increases oncotic pressure outside blood vessels (for example inflammation), or reduces oncotic pressure in the blood (states of low plasma osmolality, for example cirrhosis) will cause edema. Increased hydrostatic pressure inside the blood vessel (for example in heart failure) will have the same effect. If the permeability of the capillary walls increases, more fluid will tend to escape out of the capillary, as can happen when there is inflammation.
Causes
Causes of edema can be grouped by its extension as generalized and localized edema. Other way to classify it is by its primary mechanism: Increased capillary hydraulic pressure, hypoalbuminemia, increased capillary permeability, lymphatic obstruction or increased interstitial oncotic pressure.
Life Threatening Causes
Life threatening causes of edema are:
Common Causes
Causes by Organ System
| Cardiovascular
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Aorta-pulmonary artery fistula, aortic coarctation, capillary leak syndromes, decreased cardiac output, deep vein thrombosis, dilated cardiomyopathy, heart failure,
hypertensive heart disease, ischemic heart disease, mitral valve disease, rheumatic fever, single ventricular heart,
tricuspid atresia, tricuspid valve diseases, Uhl anomaly, varicose veins, venous stenosis, venous thrombosis.
|
| Chemical/Poisoning
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Anthrax, epidemic dropsy, St. Anthony's fire.
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| Dental
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No underlying causes
|
| Dermatologic
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Erythroderma
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| Drug Side Effect
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Aldesleukin, alitretinoin, alpha1 blockers, amlodipine, androgens, apomorphine hydrochloride, aromatase inhibitors,aspirin, azficel-T, bicalutamide,calcium channel blockers, carbenoxolone, cefaclor,
cetrorelix, chlordiazepoxide,cisplatin, conivaptan, cidofovir, conjugated estrogens, crizotinib, danazol ,
deserpidine, desmopressin, desogestrel and ethinyl estradiol, dexamethasone,diazoxide, dihydropyridine calcium channel blockers , diltiazem, docetaxel, estramustine, estrogens,ethynodiol diacetate and ethinyl estradiol, felbamate, felodipine ,fludrocortisone,flurbiprofen, fungemia, gabapentin, gallium nitrate, gestrinone, glucocorticoids, glufosinate, gold salts, hydralazine, hydrocortisone,hydroxyprogesterone caproate, imatinib mesylate, indomethacin, insulins, interleukin 11, isradipine, lenalidomide, lidocaine (cream), lidocaine (ointment), mefenamic acid, methysergide, minoxidil, nabilone,nifedipine, nilutamide, nitrendipine, nondihydropyridine calcium channel blockers, nonsteroidal anti-inflammatory drugs (NSAIDs), oxandrolone,oxaprozin,
palifermin, pegaspargase, penciclovir, pergolide, phenylbutazone ,pimavanserin,pinacidil,pioglitazone,
pramipexole, prednisolone, pregabalin, progestins, reserpine, rofecoxib, ropinirole, sargramostim,
siltuximab, sinecatechins, sodium phenylbutyrate, streptozocin, sympatholytics, tamoxifen, temsirolimus,
terconazole, testosterone, thiazolidinediones, tiagabine, tolmetin, vasodilators, Von Willebrand factor.
|
| Ear Nose Throat
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Recurring airway infection
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| Endocrine
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Cushing disease, diabetes mellitus,hepatorenal tyrosinemia, hypothyroidism, thyroid disorders
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| Environmental
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Anthrax, Boston ivy poisoning, burns
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| Gastroenterologic
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Cirrhosis , early hepatic cirrhosis, eosinophilic gastroenteritis, eosinophilic enteropathy, pattern II, gastritis, familial giant hypertrophic, hepatic cirrhosis, hepatic failure, hepatic venous obstruction, hepatitis, liver disease, liver failure, malabsorption syndrome, Ménétrier's disease, primary biliary cirrhosis, protein losing enteropathy, Waldmann disease, Whipple's disease
|
| Genetic
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Aagenaes syndrome, amnion rupture sequence, Andersen disease, aplasia cutis congenital - intestinal lymphangiectasia, C1 esterase inhibitor deficiency, cardiomyopathy - hearing loss, type T-RNA lysine gene mutation,
combined oxidative phosphorylation deficiency 5, cystic fibrosis, dextrocardia-bronchiectasis-sinusitis, distichiasis ,
ectodermal dysplasia - arthrogryposis - diabetes mellitus, encephalopathy progressive - optic atrophy, estrogen dependent hereditary angioedema, fructose-1-phosphate aldolase deficiency, hereditary, Goldberg syndrome, hemolytic disease of the newborn, ichthyosis congenita, Jacobs syndrome, microcephaly - microphthalmos - blindness, Milroy's disease, monosomy 3p14 p11, multiple joint dislocations - metaphyseal dysplasia, Neu-laxova syndrome, Noonan syndrome, Opitz-Reynolds-Fitzgerald syndrome, pulmonary lymphangiectasia, congenital, Schneckenbecken dysplasia, single ventricular heart, tricuspid atresia, Turner syndrome, type IV glycogen storage disease, tyrosinemia, Uhl anomaly, X chromosome, duplication xq13 1 q21 1, X chromosome, monosomy xp22 pter, X chromosome, monosomy xq28, X chromosome, trisomy 26-28, X chromosome, trisomy xp3, X chromosome, trisomy xpter xq13, X chromosome, trisomy xq, X chromosome, trisomy xq25.
|
| Hematologic
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Essential mixed cryoglobulinemia, hereditary angioedema.
|
| Iatrogenic
|
No underlying causes
|
| Infectious Disease
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Acanthocheilonemiasis, Chagas disease, intestinal capillariasis, Junin virus, lymphadenitis, lymphatic filariasis, Plasmodium malariae, Plasmodium ovale, sleeping sickness (east african), sleeping sickness (west african), trichinosis, west african trypanosomiasis.
|
| Musculoskeletal/Orthopedic
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No underlying causes
|
| Neurologic
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Proximal spinal muscular atrophy, spinal muscular atrophy, type II
|
| Nutritional/Metabolic
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, excessive dieting,Kwashiorkor, malnutrition, nutritional deficiency, sodium overload, thiamine deficiency, vitamin E deficiency, water overload.
|
| Obstetric/Gynecologic
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Eclampsia, Ovarian hyperstimulation syndrome, pre-eclampsia, pregnancy and premenstrual edema,pregnancy
|
| Oncologic
|
Angioimmunoblastic t-cell lymphoma,bronchogenic carcinoma, carcinoid tumours and carcinoid syndrome,
classical hodgkin disease, [Letterer-siwe disease]], malignant ascites, mixed cellularity hodgkin's disease, nodal enlargement due to malignancy, nodular sclerosing hodgkin's lymphoma
|
| Ophthalmologic
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Distichiasis , nevus of ota retinitis pigmentosa, obal syndrome
|
| Overdose/Toxicity
|
Ginseng overuse
|
| Psychiatric
|
Refeeding edema
|
| Pulmonary
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Acute pulmonary edema, adult respiratory distress syndrome, hemangiomatosis, familial pulmonary capillary,
lymphangiomatosis, pulmonary, pulmonary lymphangiectasia, congenital.
|
| Renal/Electrolyte
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Acute glomerulonephritis, acute renal failure, chronic kidney disease, glomerular disease,
hypernatremia, hypoproteinaemia, lipoprotein glomerulopathy, membranoproliferative glomerulonephritis, mesangiocapillary glomerulonephritis type 1, mesangiocapillary glomerulonephritis type III, nephritis, nephrosis, idiopathic form, familiar,
nephrotic syndrome, non-diarrheal (d-) HUS syndrome, post-streptococcal glomerulonephritis, renal disease, renal failure.
|
| Rheumatology/Immunology/Allergy
|
Acute infantile hemorrhagic oedema, allergic reaction, anaphylaxis, autoimmune disease (juvenile idiopathic arthritis & Crohn's disease), eosinophilia-myalgia syndrome, Goodpasture's syndrome, inherited hemolytic-uremic syndrome, Kawasaki disease, polyarteritis nodosa.
|
| Sexual
|
No underlying causes
|
| Trauma
|
Leg injury, trauma.
|
| Urologic
|
No underlying causes
|
| Miscellaneous
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Acute altitude sickness, bone marrow failure , cachexia, eosinophilic enteropathy, pattern II, granulomatous lymphangitis, hypernatremia, hypoproteinaemia, idiopathic edema, when diuretic induced, inflammation or sepsis, Irons-Bhan syndrome, lymph node dissection, lymphedema praecox, POEMS syndrome, protein deficiency, rheumatic fever, Tang Hsi Ryu syndrome, Yellow nail syndrome.
|
Causes in Alphabetical Order
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Organ-Specific Edema
Edema of specific organs (cerebral edema, pulmonary edema, macular edema, pedal edema) may also occur, each with different specific causes to peripheral edema, but all based on the same principles. Ascites is effectively edema within the peritoneal cavity, as pleural effusions are effectively edema in the pleural cavity. Causes of edema which are generalized to the whole body can cause edema in multiple organs and peripherally. For example, severe heart failure can cause peripheral edema, pulmonary edema, pleural effusions and ascites.
Common and usually harmless appearances of cutaneous edema are observed with mosquito bites and skin contact with certain plants (urticaria).
Edema may be found in the eyes after corrective surgery or procedures of that nature.
References
External links
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