Anasarca, or extreme generalized edema, is a general swelling of the whole body. It can occur when the tissues of the body retain too much fluid.
Accumulation of fluid may occur due to any illnesses and conditions that change the proteins of the body, affect the balance of fluids, or create abnormalities in the blood vessels or lymphatic system.
Often, if anasarca is present, it is a sign of severe organ damage or illness.
It is helpful to understand that anasarca is not a disease itself. Instead, it is a symptom or result of a medical condition.
Anasarca is different than typical edema. Almost everyone experiences swelling at some time, which can be due to a variety of causes, such as an injury, dehydration, or a minor side effect of medication.
In many instances, swelling or edema may only affect a specific part of the body, such as the feet, hands, or legs.
But with anasarca, the swelling involves the whole body and is considered severe. For example, the swelling is often so severe it makes movement difficult.
It is essential to find out what is causing anasarca to treat it accurately. For example, if kidney disease is causing anasarca, treatment is needed to assist kidney function.
Also, doctors often prescribe medications to treat the severe swelling.
Doctors often prescribe drugs called diuretics. Diuretics work by helping the kidneys release more salt into the urine, which causes the release of more fluid through urination.
The two main types of diuretics prescribed for anasarca include potassium-sparing and loop diuretics. Diuretics are either taken by mouth or given through an intravenous line (IV). The choice of diuretic, the dose, and the route of administration vary according to the severity of the swelling and the underlying condition that is causing anasarca.
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A doctor may recommend additional home treatments to speed recovery. Monitoring fluid and salt intake is important to prevent any swelling from getting worse. Salt can increase fluid retention, which is why people who have severe edema need to reduce their salt intake.
Anasarca can develop due to a variety of causes. Some conditions that may lead to anasarca are widespread, while others are considered rare.
The most common causes of anasarca include:
- Excess administration of intravenous fluids: Intravenous fluids are often administered in the hospital to treat several conditions, such as shock, dehydration, and infection. But if the body cannot adapt to the fluids given, it can lead to severe edema
- Kidney disease: When kidney function is impaired, fluid is not removed from the body adequately, which can cause anasarca.
- Cirrhosis: Cirrhosis can occur due to liver failure. Liver disease can cause changes in the hormones that affect fluid regulation in the body. When the liver does not work as efficiently as it should, it can cause fluid to leak into the tissues.
- Malnutrition: Malnutrition, specifically protein deficiency in the diet, can cause fluid to accumulate in the tissues. In extreme cases, it can lead to anasarca.
- Poor heart function: When the muscle of the heart does not work correctly, it affects how well the heart pumps blood throughout the body. If the heart is not pumping efficiently, it can cause fluid to build up in the tissues.
- Allergic reaction: Swelling of the body can occur due to an allergic reaction. In severe reactions, anasarca can develop.
Less common causes include:
Capillary leak syndrome
Capillary leak syndrome occurs when protein and fluid leak out of the blood vessels into the tissues of the body. The cause is not well understood, but it is believed to be due to inflammation and blood vessel injury. It has been shown to occur in relation to some medications and toxins.
A side effect of medication
Various medications can lead to anasarca. The most common types of medication that might cause swelling include steroids and blood pressure drugs, such as amlodipine. Discontinuing the medication will often resolve symptoms of anasarca as indicated in this case report.
The main symptom of anasarca is swelling of the body. The swelling is obvious, and the skin may look shiny and stretched. Sometimes, swelling is so extreme that a person has difficulty moving.
Swelling can become so severe that fluid will leak out directly from the skin. This is known as weeping edema.
Pitting edema may also develop. Pitting edema occurs when pressure is applied to the swollen skin, and a dimple or indentation remains after the pressure is released.
The swelling often causes additional symptoms including:
- trouble walking if the legs are swollen
- difficulty lifting arms
- increased heart rate
- aching joints
- difficulty breathing
A life-threatening complication of anasarca can also develop if fluid accumulates in the lungs. Fluid in the lungs is called pulmonary edema, and it can quickly become an emergency. Signs of pulmonary edema include chest pain, shortness of breath, and coughing.
A doctor can usually make a diagnosis of anasarca after a physical exam; and if the edema is severe, a doctor can often recognize it instantly. However, determining the underlying cause of anasarca requires further tests.
A blood test is often the first step in making a diagnosis of anasarca. Blood is tested to check the function of organs including the heart, lungs, liver, and kidneys.
A doctor will also take a medical history to help determine whether any underlying medical conditions are causing the fluid retention. A doctor may also recommend other diagnostic tests, such as an echocardiogram, a chest X-ray, and a stress test to evaluate heart and lung function.
Anasarca often occurs due to severe organ damage or illness. It may interfere with a person’s ability to perform everyday activities and can greatly decrease their quality of life. But with proper treatment, swelling can often be reduced. Although medication can help treat the condition, anasarca might return if the underlying cause cannot be corrected.
The outlook for people with anasarca often depends on identifying the cause. In many instances, by the time anasarca has developed, the underlying condition has progressed to a critical state.
Treating problems with the heart, lungs, kidneys, and liver early on is the best chance of preventing and controlling anasarca in many cases.