Plethora (medicine)

Plethora is an ancient medical sign describing an excess of body fluid.[1] The excessive fluid is usually blood, and can be a sign of a number of conditions with different causes. An excess of blood may be either an excessive blood flow to an area of the body, or an increase in the volume of blood (polycythemia). Extra perfusion to the face is termed facial plethora, a hallmark sign of Cushing's syndrome.[1] Pulmonary plethora is an increased pulmonary perfusion seen on chest X-rays. A plethora of fluid in the pericardial cavity is known as pericardial effusion.

Types

Plethora includes types of facial plethora, pulmonary plethora, and plethora of the neonate.

Facial plethora

Facial plethora is an excessive blood flow to the face and is a hallmark sign of Cushing’s syndrome. The blood flow is to the superficial capillaries of the skin.[2] The increased blood flow causes swelling of the facial tissue giving the appearance of a rounded moon face made red by the increased capillary blood flow.

Facial plethora may be a sign of Cushing's syndrome, superior vena cava syndrome, carcinoid syndrome, polycythemia vera, and rosacea. In superior vena cava syndrome compression of the vein causes upper body swelling that can lead to facial plethora.

Pulmonary plethora

Pulmonary plethora is an increased pulmonary perfusion seen on chest X-rays.[3]

Pericardial cavity

A plethora of fluid in the pericardial cavity is known as pericardial effusion.[4]

Plethora of the neonate

Plethora in the newborn, also known as polycythemia of neonates is an increase in the blood volume due in large part to the late clamping of the umbilical cord.[5] This can cause transient tachypnea of the newborn a temporary breathing problem.

References
  1. Stratakis, CA (September 2016). "Skin manifestations of Cushing's syndrome". Reviews in Endocrine & Metabolic Disorders. 17 (3): 283–286. doi:10.1007/s11154-016-9399-3. PMC 5181654. PMID 27943005.
  2. Afshari, A; Ardeshirpour, Y; Lodish, MB (October 2015). "Facial Plethora: Modern Technology for Quantifying an Ancient Clinical Sign and Its Use in Cushing Syndrome". The Journal of Clinical Endocrinology and Metabolism. 100 (10): 3928–33. doi:10.1210/jc.2015-2497. PMC 4596033. PMID 26301943.
  3. Knipe, Henry. "Pulmonary plethora | Radiology Reference Article | Radiopaedia.org". Radiopaedia. Retrieved 3 April 2023.
  4. "Pericardial Disease". www.clevelandclinicmeded.com. Retrieved 3 April 2023.
  5. Sarkar S, Rosenkrantz TS (August 2008). "Neonatal polycythemia and hyperviscosity". Seminars in Fetal & Neonatal Medicine. 13 (4): 248–255. doi:10.1016/j.siny.2008.02.003. PMID 18424246.
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