Anasarca
| Anasarca | |
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| A child with anasarca brought on by nephrosis associated with malaria | |
| Specialty | Internal medicine |
Anasarca is a severe and generalized form of edema, with subcutaneous tissue swelling throughout the body.[1] Unlike typical edema, which almost everyone will experience at some time and can be relatively benign, anasarca is a pathological process reflecting a severe disease state and can involve the cavities of the body in addition to the tissues.
Signs and symptoms
[edit]Physical appearance
[edit]Can include:
- Periorbital edema "eye puffiness"
- Perioral edema
- Upper extremity edema
- Ascites
- Lower extremity edema
- Pre-tibial edema
- Pedal edema
Physical manifestations
[edit]Can include:
Cause
[edit]Anasarca is often caused by a decreased oncotic pressure.
Organ failure
[edit]- Liver failure[2]
- Kidney failure[2]
- Right-sided heart failure[3]
Malignancy
[edit]Diet
[edit]- Severe protein deficiency[4]
Systemic manifestations of
[edit]In utero
[edit]In Hb Barts, the high oxygen affinity results in poor oxygen delivery to peripheral tissues, resulting in anasarca.[8]
Iatrogenic
[edit]It can also be caused by the administration of exogenous intravenous fluid.
Diagnosis
[edit]Anasarca is a diagnosis made clinically and differentiated from edema by extent of body involvement and severity. Whereas edema is usually graded on a mild/moderate/severe scale and usually affects one or two regions of the body, anasarca affects the several of the body and is the most severe form of edema, with subcutaneous tissue swelling from head to feet.[2]
Testing
[edit]Although there is no definitive test to prove anasarca, many tests can be useful to aid in the diagnosis. Anasarca is most often seen in conjunction with a low level of albumin.[2]
A research paper published in 2001 demonstrated a linkage between low-voltage ECG (QRS complexes of <5 mm in the limb and <10 mm in the precordial leads) and anasarca.[9]
Treatment
[edit]Anasarca is a severe symptom, not a pathological process in and of itself; as such, the best treatment is to treat the underlying cause. However, there are a number of things that can be done to help get the fluid off as well as prevent further accumulation of fluid.[citation needed]
Diuretics
[edit]One of the mainstays of any edema treatment, diuretics are a category of medications that help the body excrete fluid by altering the way in which the kidney processes urine.[10]
Diet
[edit]The body more efficiently absorbs fluid from the gut and retains that fluid with the help of sodium and sugar.[11][12] As such, decreasing salt and simple sugar intake will help prevent the accumulation of fluid and potentiate the effect of any diuretics. Following a high protein diet will help provide one's body with the substrates necessary to produce albumin, the major protein in human plasma and the single most important molecule in maintaining the serum oncotic pressure.[citation needed]
Fiber
[edit]Bulking fiber, both soluble and insoluble dietary fiber, absorbs water throughout the GI tract. Viscous fiber can thicken the contents of the GI tract and slow the absorption of other compounds (like simple sugars).[13][14]
References
[edit]- ↑ Vinay Kumar, Abbas. Robbins and Cotran Pathologic Basis of Disease. 8th ed. p.112; Philadelphia: Saunders Elsevier, 2010. ISBN 978-0-8089-2402-9
- 1 2 3 4 Kattula, Sri Rama Surya Tez; Avula, Akshay; Baradhi, Krishna M. (2020), "Anasarca", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID 30085555, retrieved 2020-07-02
- ↑ Hussain, Kifah; Mandras, Stacy A.; Desai, Sapna (2026), "Right Heart Failure", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID 29083579, retrieved 2026-07-18
- ↑ "Anasarca: Causes, treatment, and definition". medicalnewstoday.com. 2018-02-13. Retrieved 2020-07-02.
- ↑ "Nephrotic syndrome - Symptoms and causes". Mayo Clinic. Retrieved 2020-07-02.
- ↑ Yasuda, Jessica Lacy; Rufo, Paul A. (2018-02-26). "Protein-Losing Enteropathy in the Setting of Severe Iron Deficiency Anemia". Journal of Investigative Medicine High Impact Case Reports. 6 2324709618760078. doi:10.1177/2324709618760078. ISSN 2324-7096. PMC 5833205. PMID 29511696.
- ↑ Mehta, Ankita; Shah, Mansi (2016). "Case Report: Uncontrolled Anasarca: CapillaryLeak Syndrome". The Medicine Forum. The Medicine Forum: Vol. 17, Article 8. 17 (1). doi:10.29046/TMF.017.1.009. Retrieved 7 July 2020.
- ↑ "Hemoglobin Bart hydrops syndrome - NIH Genetic Testing Registry (GTR) - NCBI". www.ncbi.nlm.nih.gov. Retrieved 2026-07-18.
- ↑ Madias, JE; Bazaz, R; Agarwal, H; Win, M; Medepalli, L (September 2001). "Anasarca-mediated attenuation of the amplitude of electrocardiogram complexes: a description of a heretofore unrecognized phenomenon". Journal of the American College of Cardiology. 38 (3): 756–64. doi:10.1016/s0735-1097(01)01429-2. PMID 11527629. Measurement of voltages in millimetres (mm) is a clinical usage based on the standard ECG format.
- ↑ Morrison, Robert T. (1997-05-01). "Edema and Principles of Diuretic Use". Medical Clinics of North America. 81 (3): 689–704. doi:10.1016/S0025-7125(05)70540-X. ISSN 0025-7125. PMID 9167652.
- ↑ Whyte, L.A.; Jenkins, H.R. (October 2012). "Pathophysiology of diarrhoea". Paediatrics and Child Health. 22 (10): 443–447. doi:10.1016/j.paed.2012.05.006. ISSN 1751-7222.
- ↑ Kang, G. (2016-01-01), "Chapter 1.4 - Therapy of Viral Gastroenteritis", in Svensson, Lennart; Desselberger, Ulrich; Greenberg, Harry B.; Estes, Mary K. (eds.), Viral Gastroenteritis, Boston: Academic Press, pp. 73–88, doi:10.1016/B978-0-12-802241-2.00004-3, ISBN 978-0-12-802241-2, retrieved 2026-07-18
- ↑ Giuntini, Eliana Bistriche; Fabiana Andrea Hoffmann Sardá; Elizabete Wenzel de Menezes (2022-12-06). "The Effects of Soluble Dietary Fibers on Glycemic Response: An Overview and Futures Perspectives". Foods. 11 (23): 3934. doi:10.3390/foods11233934. ISSN 2304-8158. PMC 9736284. PMID 36496742.
- ↑ Jenkins, David J.A.; Marchie, Augustine; Augustin, Livia S.A.; Ros, Emilio; Kendall, Cyril W.C. (2004). "Viscous dietary fibre and metabolic effects". Clinical Nutrition Supplements. 1 (2): 39–49. doi:10.1016/j.clnu.2004.09.007. ISSN 1744-1161. Archived from the original on 2024-04-16.