Peripheral edema: diagnostics and treatment.

Peripheral edema: diagnostics and treatment.

Prof. L.V. Zhuravlyova , PHD A.A. Yankevich. Kharkiv National Medical University.

In this review discussion was focused on edema — the common presentation of internal diseases, neurological disorders and surgical problems. Edema is defend as abnormal accumulation of interstitial fluid, which can be either due to excessive capillary filtration or ineffective lymphatic drainage. There are systemic and local causes of edema, which should be revealed promptly, because specific etiology has significant impact on the approach to treatment. Among common causes of edema chronic venous insufficiency, heart failure, nephritic syndrome, effects of drugs, deep venous thrombosis and etc. were analyzed. Some attention was paid to specific conditions like idiopathic edema and lipidema (which is abnormal fat distribution). Diagnostic procedures and treatment options became the features of consideration regarding its effect on the management of patient with peripheral edema. In addition to the descriptive part of the article, the multi-choice questions were proposed for self-assessment.

Key Words: peripheral edema, diagnostic procedures, treatment options.

Zhuravlyova LV, Yankevich AA. [Peripheral edema: diagnostics and treatment]. Shidnoevr. z. vnutr. simejnoi med. 2014;1:15-22. Russian.
http://dx.doi.org/10.15407/10.15407/internalmed2014.01.015

Download.PDF

1. Braunwald E, Loscalzo I, Longo DL, Fauci AS, Kasper DL, Hauser SL, Iameson IL, editors. [Edema.] In: Harrisons Principles of Internal Medicine. 18th ed. New York, NY: McGraw-Hill. 2011; 4012. English
2. Trayes KP, Studdiford IS, Pickle S, Tully AS Edema: [Diagnosis and Management]. Am Fam Physician. 2013; 88 (2):102—110. English
3. Ely IW, Osheroff IA, Chambliss ML, Ebell MH [Approach to leg edema of unclear etiology]. I Am Board Fam Med. 2006; 19 (2):148—160. English
4. Cho S, Atwood IE [Peripheral edema]. Am I Med. 2002; 113 (7):580—586. English
http://dx.doi.org/10.1016/S0002-9343(02)01322-0
5. Gorman WP, Davis KR, Donnelly R [ABC of arterial and venous disease. Swollen lower limb-1: general assessment and deep vein thrombosis]. BMI. 2000; 320: 1453—1456. English
http://dx.doi.org/10.1136/bmj.320.7247.1453
6. Mortimer PS [Swollen lower limb-2: lymphedema] BMI. 2000; 320: 1527—1529. English
http://dx.doi.org/10.1136/bmj.320.7248.1527
7. Yale SH, Mazza II [Approach to diagnosing lower extremity edema]. Compr Ther. 2001; 27 (3): 242—252. English
http://dx.doi.org/10.1007/s12019-001-0021-5
8. Topham EI, Mortimer PS [Chronic lower limb oedema]. Clin Med. 2002; 2: 28—31. English
http://dx.doi.org/10.7861/clinmedicine.2-1-28
9. Tiwari A, Cheng KS, Button M, Myint F, Hamilton G [Differential diagnosis, investigation, and current treatment of lower limb lymphedema]. Arch Surg. 2003; 138: 152— 161. English
http://dx.doi.org/10.1001/archsurg.138.2.152
10. Hermitte LF, Behar A, Paries I, Cohen-Boulakia F, Attali IR, Valensi P. [Impairment of lymphatic function in women with gynoid adiposity and swelling syndrome]. Metabolism. 2003; 52: 805—809. English
http://dx.doi.org/10.1016/S0026-0495(03)00094-5
11. Ageno W, Piantanida E, Dentali F. [Body mass index is associated with the development of the postthrombotic syndrome]. Thromb Haemost. 2003; 89: 305— 309. English
12. Villeco IP. [Edema: a silent but important factor]. I Hand Ther. 2012; 25 (2): 153—162. English
http://dx.doi.org/10.1016/j.jht.2011.09.008
13. Maisel AS, Krishnaswamy P, Nowak RM. [Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure]. N Engl I Med. 2002; 347: 161—167. English
http://dx.doi.org/10.1056/NEJMoa020233
14. Kesieme E, Kesieme C, Iebbin N, Irekpita E, Dongo A. [Deep vein thrombosis: a clinical review]. I Blood Med. 2011; 2: 59—69. English
http://dx.doi.org/10.2147/JBM.S19009
15. Iftikhar I, Ahmed M, Tarr S, Zyzanski SI, Blankfield RP. [Comparison of obstructive sleep apnea patients with and without leg edema]. Sleep Med. 2008; 9 (8): 890—893. English
http://dx.doi.org/10.1016/j.sleep.2007.10.019
16. Brotman DI, Segal IB, Iani IT, Petty BG, Kickler TS. [Limitations of d-dimer testing in unselected inpatients with suspected venous thromboembolism]. Am I Med. 2003; 114 (4) : 276—282. English
http://dx.doi.org/10.1016/S0002-9343(02)01520-6
17. Umeoka S, Koyama T, Togashi K, Kobayashi H, Akuta K. [Vascular dilatation in the pelvis: identification with CT and MR imaging]. Radiographics. 2004; 24 (1): 193—208. English
http://dx.doi.org/10.1148/rg.241035061
18. McMurray II, Adamopoulos S, Anker SD. [ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012]. Eur Heart I. 2012; 33: 1787—1847. English
http://dx.doi.org/10.1093/eurheartj/ehs104
19. Tsochatzis EA, Bosch I, Burroughs AK. [Liver cirrhosis]. Lancet. 2014; 383: 1749—1761. English
http://dx.doi.org/10.1016/S0140-6736(14)60121-5
20. Kodner C. [Nephrotic syndrome in adults: diagnosis and management]. Am Fam Physician. -2009; 80 (10): 1129—1134. English
21. Blaauw R. [Malabsorption: causes, consequences, diagnosis and treatment]. S Afr I Clin Nutr. 2011; 24 (3): 125—127. English
22. Gharibeh T, Mehra R. [Obstructive sleep apnea syndrome: natural history, diagnosis, and emerging treatment options] Nature and Science of Sleep. 2010; 2: 233—255. English
23. Cicardi M, Zanichelli A. [Acquired angioedema]. Allergy Asthma Clin Immunol. 2010; 6: 14. English
http://dx.doi.org/10.1186/1710-1492-6-14
24. Seippel L, Eriksson O, Grankvist K, Shoultz VB, Backstrom T. [Physical symptoms in premenstrual syndrome are related to plasma progesterone and desoxycorticosterone]. Gynecol Endocrinol. 2000; 14: 173—181. English
http://dx.doi.org/10.3109/09513590009167679
25. Zagrosek V, Blomstrom LC, Borghi C, Cifkova R, Ferreira R. [ESC Guidelines on the management of cardiovascular diseases during pregnancy. The Task Force on the Management of Cardiovascular Diseases during Pregnancy of the European Society of Cardiology (ESC)]. Eur Heart I. 2011; 32: 3147—3197. English
http://dx.doi.org/10.1093/eurheartj/ehr218
26. Messerli FH. [Vasodilatory edema: a common side effect of antihypertensive therapy]. Curr Cardiol Rep. 2002; 4: 479 — 482. English
http://dx.doi.org/10.1007/s11886-002-0110-9
27. Niemeyer NV, Ianney LM. [Thiazolidinedione-induced edema] Pharmacotherapy. 2002; 22: 924—929. English
http://dx.doi.org/10.1592/phco.22.11.924.33626
28. Inomata N. [Recent advances in drug-induced angioedema]. Allergol Int. 2012; 61: 545-557. English
http://dx.doi.org/10.2332/allergolint.12-RAI-0493
29. Schwartz KM, Fatourechi V, Ahmed DD. [Dermopathy of Graves disease (pretibial myxedema): long-term outcome]. I Clin Endocrinol Metab. 2002; 87 (2): 438— 446. English
30. Garber IR, Cobin RH, Gharib H. [Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association]. Thyroid. 2012; 22 (12): 1200—1235. English
http://dx.doi.org/10.1089/thy.2012.0205
31. Prinzo ZW, World Health Organization [Thiamine deficiency and its prevention and control in maior emergencies]. In: Review. 1999; 52. English
32. Eberhardt RT, Raffetto ID [Chronic venous insufficiency.]. Circulation. 2005; 111: 2398—2440. English
http://dx.doi.org/10.1161/01.CIR.0000164199.72440.08
33. Swartz MN [Cellulitis]. N Engl I Med. 2004; 350: 904—912. English
http://dx.doi.org/10.1056/NEJMcp031807
34. Mabvuure NT, Malahias M, Hindocha S, Khan W, Iuma A [Acute Compartment Syndrome of the Limbs: Current Concepts and Management].The Open Orthopaedics Journal. 2012; 6 (3): 535—543. English
http://dx.doi.org/10.2174/1874325001206010535
35. Turner-Stokes L [Reflex sympathetic dystrophy — a complex regional pain syndrome]. Disability and Rehabilitation. 2002; 24 (18): 939 — 947. English
http://dx.doi.org/10.1080/0963828021000007950
36. Butros SR, Liu R, Oliveira GR, Ganguli S, Kalva S [Venous compression syndromes: clinical features, imaging findings and management]. Br I Radiol. 2013; 86: 2013—2084. English
37. Warren AG, Brorson H, Borud LI, Slavin SA [Lymphedema: a comprehensive review]. Ann Plast Surg. 2007; 59: 464—472. English
http://dx.doi.org/10.1097/01.sap.0000257149.42922.7e
38. Forner-Cordero I, Szolnoky G, Forner-Cordero A, Kemény L [Lipedema: an overwiew of its clinical manifestations diagnosis and treatment of the disproportional fatty deposition syndrome-systematic review]. Clin Obes. 2012; 2: 86—95. English
http://dx.doi.org/10.1111/j.1758-8111.2012.00045.x