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Therapeutische Umschau. Revue... Oct 1998The legs are preferentially affected by systemic edematous states. Pathogenetic factors are: increased hydrostatic pressure, increased capillary permeability (leak),... (Review)
Review
The legs are preferentially affected by systemic edematous states. Pathogenetic factors are: increased hydrostatic pressure, increased capillary permeability (leak), reduced colloid-oncotic pressure, reduced lymph drainage and miscellaneous rare conditions. The most frequent cause of increased hydrostatic pressure is right heart failure, which can be treated with diuretic drugs. Increased capillary leak is seen in septic-toxic events, where the underlying disease must be treated. Reduced oncotic pressure is caused by hypoalbuminemia, either due to reduced production, e.g., in liver cirrhosis, or to increased albumin loss, e.g., through the kidney in nephrotic syndrome or the gut in protein-loosing enteropathy. Lymphedema is classified either as primary or secondary and is treated by lymph drainage. Idiopathic edemas, primarily seen in females, often lead to chronic abuse of diuretics, which in turn can cause diuretic-induced edemas.
Topics: Diagnosis, Differential; Edema; Humans; Leg
PubMed: 9828697
DOI: No ID Found -
Human Psychopharmacology Nov 2023Oedema associated with psychotropics can impose a considerable burden, leading to increased morbidity and cost. Peripheral oedema is sometimes related to the use of... (Review)
Review
BACKGROUND
Oedema associated with psychotropics can impose a considerable burden, leading to increased morbidity and cost. Peripheral oedema is sometimes related to the use of antidepressants, which are among the most prescribed psychotropic medications. We reviewed the reported cases of antidepressant-associated oedema to understand the risk factors, aetiology and outcome.
METHODS
We searched the Medline, Web of Science and Embase databases to identify reported cases of peripheral oedema associated with antidepressant use. We included studies published in English and those with full-text availability. A systematic review of the reports was done to identify the antidepressants associated with oedema, explore possible risk factors, investigate potential mechanisms, and assess the outcome.
RESULTS
We identified a total of 45 cases (27 case reports and five case series) that reported oedema associated with antidepressant use. Almost all major classes of antidepressants were found to be associated with oedema. Among these drugs, trazodone, mirtazapine, and escitalopram were the most implicated. Older age and female gender were more commonly associated with oedema. Etiologically, antagonism of α adrenergic receptors and 5HT receptors, leading to vasodilation and oedema, emerged as the most prevalent mechanisms. In most cases, the oedema subsided following the discontinuation of the antidepressants.
CONCLUSIONS
Peripheral oedema associated with antidepressant use can represent a significant adverse drug reaction involving various classes of antidepressants. To ensure timely identification and proper management of oedema, regular monitoring is crucial.
Topics: Humans; Female; Antidepressive Agents; Mirtazapine; Risk Factors; Edema
PubMed: 37941526
DOI: 10.1002/hup.2884 -
Ugeskrift For Laeger Apr 2023Pedal oedema is a well-known adverse effect of amlodipine, but significantly less frequent if only half of the maximum recommended dosage is used. Diuretics are... (Review)
Review
Pedal oedema is a well-known adverse effect of amlodipine, but significantly less frequent if only half of the maximum recommended dosage is used. Diuretics are ineffective. To cause as few side effects as possible, options for managing are prioritised in this review: Reduce dosage, switch to lercanidipine/lacidipine, switch to another group, add/increase dosage of an ACE-inhibitor/angiotensin II-receptor blocker, administer at night, or switch to verapamil/diltiazem. Non-pharmacologic actions or observation may be considered when the oedemas are mild and not bothersome.
Topics: Humans; Amlodipine; Calcium Channel Blockers; Hypertension; Ankle; Edema; Drug-Related Side Effects and Adverse Reactions
PubMed: 37114573
DOI: No ID Found -
Nature Reviews. Cardiology Mar 2013Oedema is one of the fundamental features of heart failure, but the pathophysiology of oedema varies. Patients present along a spectrum ranging from acute pulmonary... (Review)
Review
Oedema is one of the fundamental features of heart failure, but the pathophysiology of oedema varies. Patients present along a spectrum ranging from acute pulmonary oedema to gross fluid retention and peripheral oedema (anasarca). In patients with pure pulmonary oedema, the problem is one of acute haemodynamic derangement; the patient does not have excess fluid, but pulmonary venous pressure rises such that the rate of fluid transudation into the interstitium of the lung exceeds the capacity of the pulmonary lymphatics to drain away the fluid. Conversely, in patients with peripheral oedema, the problem is one of fluid retention. Understanding the causes of oedema will enable straightforward, correct management of the condition. For patients with acute pulmonary oedema, vasodilatation is important to reduce cardiac filling pressures. For patients with fluid retention, removing the fluid, using either diuretics or mechanical means, is the most important consideration.
Topics: Aged; Capillary Permeability; Edema; Female; Heart Failure; Hemodynamics; Humans; Male; Prognosis; Pulmonary Edema; Risk Factors; Water-Electrolyte Balance
PubMed: 23319101
DOI: 10.1038/nrcardio.2012.191 -
Clinical and Experimental Rheumatology 2016Remitting seronegative symmetrical synovitis with pitting oedema (RS(3)PE) syndrome is a rare inflammatory arthritis, characterised by symmetrical distal synovitis,... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
Remitting seronegative symmetrical synovitis with pitting oedema (RS(3)PE) syndrome is a rare inflammatory arthritis, characterised by symmetrical distal synovitis, pitting oedema of the hands and feet, absence of rheumatoid factor, and favourable response to glucocorticoids. The aim of our study is to further delineate the clinical and laboratory features, and response to treatment.
METHODS
We performed a systematic electronic search of Medline, PubMed, EMBASE, ACR and EULAR databases for case reports, case series, and related articles of RS(3)PE. Statistical analysis was done comparing categorical variables with Chi-square tests and frequencies of means via t-tests. Binary logistic regression analysis was performed to identify predictors of erosions, recurrence, malignancy and rheumatologic disorders.
RESULTS
331 cases of RS(3)PE were identified from 121 articles. RS(3)PE was found in older patients (71±10.42 years) predominantly in males (n= 211, 63.36%), was symmetrical (n=297/311, 95.50%) involved the hands (n=294/311, 94.53%) A concurrent rheumatologic condition was reported in 22 cases (6.65%), and malignancy in 54 cases (16.31%). Radiographic joint erosions were found in 5.5%. Most patients responded to medium-dose glucocorticoids (16.12±9.5 mg/day). Patients with concurrent malignancy requiring non-significantly higher doses of prednisone (18.12 vs. 15.76 mg, p 0.304) and higher likelihood of recurrence of disease (OR 4.04, 95% CI 1.10-14.88, p=0.03).
CONCLUSIONS
The symptoms and unique findings that make up RS(3)PE appear to represent a steroid-responsive disease that may be a harbinger of an underlying malignancy. More study is needed to understand the molecular origins of RS(3)PE in order to determine whether it is a separate disease process. Patients with concurrent cancer tend to have more severe presentations and higher rates of recurrence.
Topics: Disease Management; Edema; Foot; Glucocorticoids; Hand; Humans; Recurrence; Serologic Tests; Symptom Assessment; Syndrome; Synovitis
PubMed: 27050250
DOI: No ID Found -
ESC Heart Failure Oct 2020The presence of chronic heart failure (CHF) results in a significant risk of leg oedema. Medical compression (MC) treatment is one of the basic methods of leg oedema... (Review)
Review
The presence of chronic heart failure (CHF) results in a significant risk of leg oedema. Medical compression (MC) treatment is one of the basic methods of leg oedema elimination in patients with chronic venous disease and lymphedema, but it is not routinely considered in subjects with CHF-related swelling. In the study, an overview of the current knowledge related to the benefits and risk of using MC in the supportive treatment of leg oedema in CHF patients is presented. The available studies dedicated the comprehensive management of leg swelling using MC in CHF patients published in the English language literature till December 2019 were evaluated in term of the treatment efficacy and safety. In studies performed on CHF populations, manual lymphatic drainage, MC stocking, multilayer bandaged, as well as intermittent pneumatic compression or electric calf stimulations were used. The current evidence is based on non-randomized studies, small study cohorts, as well as very heterogenous populations. The use of the intermittent pneumatic compression in CHF patients significantly increases the right auricular pressure and mean pulmonary artery pressures as well as decreases systemic vascular resistance in most patients without the clinical worsening. The transient and rapid increase in the human atrial natriuretic peptide, after an application of the MC stocking in New York Heart Association (NYHA) class II patients was observed without clinical exacerbation. An application of the multilayer bandages in NYHA classes III and IV patients lead a significant increase in the right arterial pressure and lead to transient deterioration of the right and the left ventricular functions. In the manual lymphatic drainage study, aside from expected leg circumference reduction, no clinical worsening was observed. In a pilot study performed in a small cohort of CHF patients, electrical calf stimulation use resulted in a reduction in the lean mass of the legs without cardiac function worsening. The use of local leg compression can be considered stable CHF patients without decompensated heart function for both CHF-related oedema treatment and for treatment of the concomitant diseases leading to leg swelling occurrence. The use of MC in more severe classes of CHF (NYHA III and IV) should be the subject of future clinical studies to select the safest and most efficient compression method as well as to select the patients who benefit most from this kind of treatment.
Topics: Edema; Heart Failure; Humans; Leg; Pilot Projects; Pressure
PubMed: 32710511
DOI: 10.1002/ehf2.12848 -
Hispalis Medica; Revista Sevillana de... Oct 1947
Topics: Edema; Humans
PubMed: 18916213
DOI: No ID Found -
Ugeskrift For Laeger Oct 2022Multiple inflammatory syndrome in children (MIS-C) has casuistically been reported in conjunction with retropharyngeal oedema. This case report details the diagnosis and...
Multiple inflammatory syndrome in children (MIS-C) has casuistically been reported in conjunction with retropharyngeal oedema. This case report details the diagnosis and treatment of MIS-C in a 13-year-old girl where the initial treatment was targeted against the retropharyngeal oedema. The aim is to highlight the atypical presentation of MIS-C.
Topics: Child; Female; Humans; Adolescent; Edema; Mucocutaneous Lymph Node Syndrome
PubMed: 36331318
DOI: No ID Found -
Ugeskrift For Laeger Nov 2017Idiopathic oedema is a non-inflammatory interstitial oedema seen in fertile women. A hallmark is a daily increase in weight > 1.4 kg from morning until evening due to... (Review)
Review
Idiopathic oedema is a non-inflammatory interstitial oedema seen in fertile women. A hallmark is a daily increase in weight > 1.4 kg from morning until evening due to fluid retention, which shows as facial puffiness in the morning and more often abdominal increase and swollen lower extremities during the day. Patients may be disabled due to accompanying symptoms like headache, dizziness, fatigue, anxiety, and depression. The diagnosis is based on clinical features and exclusion of other causes of oedema. Non-pharmacological interventions and pharmacological therapies are reviewed.
Topics: Adult; Diagnosis, Differential; Edema; Female; Humans; Middle Aged; Weight Gain
PubMed: 29208198
DOI: No ID Found -
British Journal of Community Nursing Apr 2020
Topics: Behavior Therapy; Chronic Disease; Edema; Humans; Lipedema; Practice Guidelines as Topic
PubMed: 32271102
DOI: 10.12968/bjcn.2020.25.Sup4.S5