Anasarca patient information: Difference between revisions
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==What are the symptoms of [[Anasarca]]== | ==What are the symptoms of [[Anasarca]]== | ||
The following questions should be asked to the [[patient]] regarding [[edema]]. | The following questions should be asked to the [[patient]] regarding [[edema]].<ref name="pmid11569326">{{cite journal| author=Yale SH, Mazza JJ| title=Approach to diagnosing lower extremity edema. | journal=Compr Ther | year= 2001 | volume= 27 | issue= 3 | pages= 242-52 | pmid=11569326 | doi=10.1007/s12019-001-0021-5 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11569326 }} </ref><ref name="pmid16513903">{{cite journal| author=Ely JW, Osheroff JA, Chambliss ML, Ebell MH| title=Approach to leg edema of unclear etiology. | journal=J Am Board Fam Med | year= 2006 | volume= 19 | issue= 2 | pages= 148-60 | pmid=16513903 | doi=10.3122/jabfm.19.2.148 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16513903 }} </ref><ref name="pmid11871635">{{cite journal| author=Topham EJ, Mortimer PS| title=Chronic lower limb oedema. | journal=Clin Med (Lond) | year= 2002 | volume= 2 | issue= 1 | pages= 28-31 | pmid=11871635 | doi=10.7861/clinmedicine.2-1-28 | pmc=4953165 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11871635 }} </ref> | ||
*Onset of the [[swelling]]: acute or chronic | *Onset of the [[swelling]]: acute or chronic | ||
*Characteristic: pitting and non-pitting edema | |||
*Timing of the day when the [[swelling]] is worst. | *Timing of the day when the [[swelling]] is worst. | ||
*Location of [[swelling]]. Whether it is unilateral or bilateral. | *Location of [[swelling]]. Whether it is unilateral or bilateral. | ||
Revision as of 21:10, 1 September 2020
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mydah Sajid, MD[2]
Overview
Anasarca is the presence of excess fluid in the interstitial space throughout the body.
What are the symptoms of Anasarca
The following questions should be asked to the patient regarding edema.[1][2][3]
- Onset of the swelling: acute or chronic
- Characteristic: pitting and non-pitting edema
- Timing of the day when the swelling is worst.
- Location of swelling. Whether it is unilateral or bilateral.
- Tenderness in the swelling.
- Change in color or blisters at the site of the swelling.
- The exacerbation of edema with changes in the position of the patient.
- Dependent edema occurs in venous insufficiency. It improves with the elevation of legs. The edema with reduced plasma oncotic pressure as underlying etiology is not improved by elevating the legs.
- Medication history.
- Medical history. Any coexisting heart, renal, or liver disease.
What causes Anasarca
- Exacerbation of congestive heart failure
- Exacerbation of chronic renal disease
- Hepatic cirrhosis
- Kwashiorkor disease
- Nephrotic syndrome
- Pregnancy
- Allergic reactions (anaphylaxis or urticaria)
- Adverse effects of medications (beta-blockers, calcium channel blockers, alpha-methyl dopa, corticosteroids, testosterone, estrogen, cyclophosphamide, cyclosporine)
Who is at the Highest Risk
- Poorly controlled underlying systematic diseases.
- Severe malnutrion
- Exposure to allergens
Diagnosis
The diagnostic study of choice depends upon the underlying etiology. The following tests should be carried out:
- Serum BNP, Chest X-ray and Cardiac Echocardiography: To assess heart failure in cardiac failure patients.
- Serum creatinine, blood urea nitrogen, complete metabolic profile and renal ultrasound: To assess renal functions in chronic kidney disease patients.
- Liver function tests and coagulation profile test: In patients with liver cirrhosis.
- Serum albumin level: In protein losing nephropathy, decrease protein intake, and deranged liver functions.
- Nocturnal sleep studies in obstructive sleep apnea patients.
Treatment Options
Medical therapies should be specifically directed towards underlying etiology.
- Diuretics, oxygen, inotropic drugs, and vasodilators in cardiac patients.
- Hemodialysis, vitamin D, and erythropoietin for end-stage renal disease patients.
- Lactulose, diuretics, and antibiotics in hepatic cirrhosis patients.
- I/V adrenaline, intravenous fluids, and inhaled bronchodilators are administered in patients with allergic reactions.
Prevention
- Leg elevation and pneumatic compression stocking to promote venous and lymphatic drainage from lower limbs.[4][5]
- Edema in lower limbs increases the risk for skin breakouts and, venous ulcers. Topical corticosteroid creams and emollients are applied to hydrate the skin and prevent cutaneous infection.[6]
Sources
- ↑ Yale SH, Mazza JJ (2001). "Approach to diagnosing lower extremity edema". Compr Ther. 27 (3): 242–52. doi:10.1007/s12019-001-0021-5. PMID 11569326.
- ↑ Ely JW, Osheroff JA, Chambliss ML, Ebell MH (2006). "Approach to leg edema of unclear etiology". J Am Board Fam Med. 19 (2): 148–60. doi:10.3122/jabfm.19.2.148. PMID 16513903.
- ↑ Topham EJ, Mortimer PS (2002). "Chronic lower limb oedema". Clin Med (Lond). 2 (1): 28–31. doi:10.7861/clinmedicine.2-1-28. PMC 4953165. PMID 11871635.
- ↑ Alguire PC, Mathes BM (1997). "Chronic venous insufficiency and venous ulceration". J Gen Intern Med. 12 (6): 374–83. doi:10.1046/j.1525-1497.1997.00063.x. PMC 1497122. PMID 9192256.
- ↑ Berliner E, Ozbilgin B, Zarin DA (2003). "A systematic review of pneumatic compression for treatment of chronic venous insufficiency and venous ulcers". J Vasc Surg. 37 (3): 539–44. doi:10.1067/mva.2003.103. PMID 12618689.
- ↑ Trayes KP, Studdiford JS, Pickle S, Tully AS (2013). "Edema: diagnosis and management". Am Fam Physician. 88 (2): 102–10. PMID 23939641.