View source for Anasarca

{{Short description|Medical condition of severe edema}}
{{Infobox medical condition (new)
| name            = Anasarca
| image           = Plasmodium falciparum nephrosis edema PHIL 3894 lores.jpg
| caption         = A child with anasarca brought on by [[nephrosis]] associated with [[malaria]]
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| field           = [[Internal medicine]]
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'''Anasarca''' is a severe and generalized form of [[edema]], with subcutaneous tissue swelling throughout the body.<ref>Vinay Kumar, Abbas. ''Robbins and Cotran Pathologic Basis of Disease''. 8th ed. p.112; Philadelphia: Saunders Elsevier, 2010. {{ISBN|978-0-8089-2402-9}}</ref> 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==
===Physical appearance===
Can include:
* Periorbital edema "[[eye puffiness]]"
* Perioral [[edema]]
* Upper extremity [[edema]]
* [[Ascites]]
* Lower extremity [[edema]]
* Pre-tibial [[edema]]
* [[Pedal edema]]

===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 ===
* [[Liver failure]]<ref>{{Citation|last1=Kattula|first1=Sri Rama Surya Tez|title=Anasarca|date=2020|url=https://www.ncbi.nlm.nih.gov/books/NBK519013/|work=StatPearls|place=Treasure Island (FL)|publisher=StatPearls Publishing|pmid=30085555|access-date=2020-07-02|last2=Avula|first2=Akshay|last3=Baradhi|first3=Krishna M.}}</ref>
* [[Kidney failure]]{{medical citation needed|date=July 2023}}
* Right-sided [[heart failure]]{{medical citation needed|date=March 2023}}

=== Malignancy ===
=== Diet ===
* Severe [[malnutrition|protein deficiency]]<ref>{{Cite web|date=2018-02-13|title=Anasarca: Causes, treatment, and definition|url=https://www.medicalnewstoday.com/articles/320906|access-date=2020-07-02|website=medicalnewstoday.com|language=en}}</ref>

=== Systemic manifestations of ===
* [[Nephrotic syndrome]]<ref>{{Cite web|title=Nephrotic syndrome - Symptoms and causes|url=https://www.mayoclinic.org/diseases-conditions/nephrotic-syndrome/symptoms-causes/syc-20375608|access-date=2020-07-02|website=Mayo Clinic|language=en}}</ref>
* [[Protein-losing enteropathy|Protein-losing enteropathies]]<ref>{{Cite journal|last1=Yasuda|first1=Jessica Lacy|last2=Rufo|first2=Paul A.|date=2018-02-26|title=Protein-Losing Enteropathy in the Setting of Severe Iron Deficiency Anemia|journal=Journal of Investigative Medicine High Impact Case Reports|volume=6|doi=10.1177/2324709618760078|issn=2324-7096|pmc=5833205|pmid=29511696}}</ref>
* [[Capillary leak syndrome]]<ref>{{Cite journal|last1=Mehta|first1=Ankita|last2=Shah|first2=Mansi|date=2016|title=Case Report: Uncontrolled Anasarca: CapillaryLeak Syndrome|journal=The Medicine Forum|url=https://jdc.jefferson.edu/tmf/vol17/iss1/8/|access-date=7 July 2020|series=The Medicine Forum: Vol. 17, Article 8|volume=17|issue=1| doi=10.29046/TMF.017.1.009|doi-access=free}}</ref>

=== In utero ===
In [[Hemoglobin Barts|Hb Barts]], the high oxygen affinity results in poor oxygen delivery to peripheral tissues, resulting in anasarca.{{cn|date=March 2023}}

=== 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.{{cn|date=March 2023}}

===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]].{{cn|date=March 2023}}

A research paper published in 2001 demonstrated a linkage between low-voltage [[ Electrocardiography |ECG]] ([[QRS complex]]es of <5&nbsp;mm in the limb and <10&nbsp;mm in the precordial leads) and anasarca.<ref>{{cite journal |last1=Madias |first1=JE |last2=Bazaz |first2=R |last3=Agarwal |first3=H |last4=Win |first4=M |last5=Medepalli |first5=L |title=Anasarca-mediated attenuation of the amplitude of electrocardiogram complexes: a description of a heretofore unrecognized phenomenon. |journal=Journal of the American College of Cardiology |date=September 2001 |volume=38 |issue=3 |pages=756–64 |doi=10.1016/s0735-1097(01)01429-2 |pmid=11527629|doi-access=free }} Measurement of voltages in millimetres (mm) is a clinical usage based on the standard [[ ECG#Background grid |ECG format]]. </ref>

==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.{{cn|date=March 2023}}

===Diuretics===
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.{{cn|date=March 2023}}
* [[Loop diuretic]]s
* [[Thiazide]] diuretics
* [[Thiazide-like diuretic]]s
* [[Potassium-sparing diuretic]]s

===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 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]].{{cn|date=March 2023}}

====Fiber====
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).{{cn|date=March 2023}}

== References ==
{{reflist}}

== External links ==
{{Medical resources
|   ICD10       = {{ICD10|R|60|1|r|50}}
|   ICD9        = {{ICD9|782.3}}
|   DiseasesDB     = 9148
|   MedlinePlus = 003103 
|   MeshID         = D004487
}}
{{Skin and subcutaneous tissue symptoms and signs}}
{{Disorders of volume state}}

[[Category:Medical signs]]
[[Category:Symptoms and signs: Skin and subcutaneous tissue]]