Abstract
Idiopathic edema (IE), a disorder of females, is characterized by edema and weight
gains exceeding 1.4 kg while assuming an upright position followed by nocturia and
returning to a non-edematous baseline weight in the morning. There is no successful
treatment of IE and the importance of nocturia needs to be emphasized. The major underlying
abnormality is an increase in vascular membrane permeability (VMP). We present four
cases with differing degrees of IE who were successfully managed by manipulating Starling's
forces. While we could not alter the increase in VMP, manipulating oncotic and hydrostatic
pressures between both compartments were untenable except to decrease intravascular
hydrostatic pressure by sodium restriction. All four cases virtually eliminated daily
weight gains and nocturia to improve quality of life considerably, two with the assistance
of daily hydrochlorothiazide (HCTZ) and all four by furosemide to accelerate recovery
from the weight gain to permit occasional dietary indiscretions to improve quality
of life. Two cases with milder forms of IE did not quantify sodium intake as meticulously
as cases one and four, who appeared to have greater increases in VMP. IE can be treated
successfully by sodium restriction with or without use of HCTZ and furosemide to eliminate
the distressing edema, weight gain and nocturia with marked improvement in emotional
instability after understanding that the weight gains and nocturia were linked to
dietary intake of sodium.
Key Indexing Terms
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Article info
Publication history
Published online: March 08, 2022
Accepted:
December 17,
2021
Received:
March 22,
2021
Identification
Copyright
© 2022 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
