Last update:
07-Jul-2004

Idiopathic cyclic edema is a chronic disorder occurring almost exclusively in women with emotional instability and is characterized by intermittent bouts of generalized swelling aggravated by standing and by stress. The diagnosis is one of exclusion of all other known causes of edema formation. The case is reported of a 57 year-old woman who attended the outpatient clinic due to relapsing edema in several parts of the body. The patient had a negative family and personal history for allergies and had never been admitted to hospital or ever received drugs for a long time span. Laboratory tests and radiology were within normal limits. Diagnosis was made using water loading testing, both lying and upright positions. During this test a significant weight gain due to water retention was noted in the upright position. The cause of idiopathic edema is uncertain. It has been reported that patients when standing present hypovolemia due to capillary leak, with resultant stimulation of the renin-aldosterone axis, antidiuretic hormone secretion and the sympathetic nervous system. These conditions result in sodium and water retention. The treatment of idiopathic edema is difficult and includes control of laxative and diuretic abuse and modification of dietary/lifestyle patterns including salt intake and depression. Amiloride, spironolactone, cholinergic drugs and even amphetamines have also been reported to produce symptom remission or complete relief.

Key words: Edema, Edema pathophysiology, Idiopathic cyclic edema, Psychiatric edema, Relapsing edema.