Anasarca

Anasarca
A child with anasarca brought on by nephrosis associated with malaria
SpecialtyInternal medicine

Anasarca is a severe and generalized form of edema, with subcutaneous tissue swelling throughout the body.[1] Unlike 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

Physical appearance

Can include:

Physical manifestations

Can include:

  • Impaired vision, difficulty opening eyes
  • Shortness of breath (SOB), dyspnea on exertion (DOE), orthopnea
  • Chest pain
  • Extreme discomfort
  • Debilitation

Cause

Anasarca is often caused by a decreased oncotic pressure.

Organ failure

Malignancy

Diet

Systemic manifestations of

In utero

In Hb Barts, the high oxygen affinity results in poor oxygen delivery to peripheral tissues, resulting in anasarca.

Iatrogenic

It can also be caused by the administration of exogenous intravenous fluid.

Diagnosis

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 entire body and is the most severe form of edema, with subcutaneous tissue swelling from head to feet.

Testing

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

Recent studies have demonstrated a linkage between low-voltage electrocardiogram (ECG) (LVE) (QRS complexes of <5 mm in the limb and <10 mm in the precordial leads) and Anasarca.[8]

Treatment

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.

Diuretics

One of the mainstays of any edema treatment, diuretics are a category of medications that help the body pee out fluid by altering the way in which the kidney processes urine.

Diet

The body more efficiently absorbs fluid from the gut and retains that fluid with the help of sodium and sugar. As such, decreasing salt and simple sugar intake will help prevent accumulation of fluid and potentiate the effect of any diuretics. Following a high protein diet will help provide your 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.

Fiber

Bulking fiber, both soluble and insoluble dietary fiber, absorb water throughout your GI tract. Viscous fiber can thicken the contents of the GI track and slow the absorption of other compounds (like simple sugars).

References

  1. ↑ Kumar Vinay. Robbins and Cotran Pathologic Basis of Disease. 8th ed. p.112; Philadelphia: Saunders Elsevier, 2010. ISBN 978-0-8089-2402-9
  2. ↑ Kattula, Sri Rama Surya Tez; Avula, Akshay; Baradhi, Krishna M. (2020), "Anasarca", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID 30085555, retrieved 2020-07-02
  3. ↑ "Anasarca: Causes, Edema, and Treatment". Healthline. 2017-07-11. Retrieved 2020-07-02.
  4. ↑ "Anasarca: Causes, treatment, and definition". medicalnewstoday.com. 2018-02-13. Retrieved 2020-07-02.
  5. ↑ "Nephrotic syndrome - Symptoms and causes". Mayo Clinic. Retrieved 2020-07-02.
  6. ↑ 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. doi:10.1177/2324709618760078. ISSN 2324-7096. PMC 5833205. PMID 29511696.
  7. ↑ 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.
  8. ↑ 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.
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