Anasarca

Edema is characterized by the collection of excess fluid in the interstitial space. Anasarca is severe edema characterized by generalized swelling throughout the body. The main underlying cause of edema is an imbalance in the hemodynamic status of the capillaries resulting in excess filtration of fluid in the intercellular space due to increased hydrostatic pressure, increased permeability of the capillaries and decreased oncotic pressure. It exceeds the absorptive capacity of lymph vessels. It can be caused by systemic diseases including chronic heart failure, liver cirrhosis, hypersensitivity reaction, and chronic renal failure.

The edema is classified in different types depending upon the severity of fluid accumulation assessed clinically:^[1]

Life-threatening causes include conditions that may result in death or permanent disability within 24 hours if left untreated.

• Burns
• Anaphylaxis

Common causes of anasarca may include the following:^[2][3][4][5]

• Congestive cardiac failure
• Urticaria
• Hepatic cirrhosis
• Renal failure
• Kwashiorkor disease
• Obstructive sleep apnea
• Pregnancy
• Nephrotic syndrome
• Use of certain medications (Beta blockers, calcium channel blockers, clonidine, methyldopa, hydralazine, androgen, corticosteroid)

On the basis of onset of symptoms, ascities, and hypertension, anasarca must be differentiated from congestive heart failure, chronic kidney disease, liver cirrhosis, anaphylaxis, nephrotic syndrome, and protein-calorie malnutrition.^{[6][7][8][9][10][11][12][13][14][15][16][17]}

Abbreviations: CVP: Central venous pressure, BNP: Brain natriuretic peptide, LVEF: Left ventricular ejection fraction, ALP: Alkaline phosphatase, AST: Aspartate transferase, ALT: Alanine transferase, GGT: Gamma Glutamyl transferase, BUN: Blood urea nitrogen, N: Normal, TAG: Triglycerides, URTI: Upper respiratory tract infection, USG: Ultrasound, hcG: human chorionic gonadotropin, BMI: Body mass index, N/A: Not applicable.

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