IDIOPATHIC EDEMA OF WOMEN

  • 1 January 1976
    • journal article
    • research article
    • Vol. 45  (177) , 125-144
Abstract
Patients (19) with idiopathic edema are reported. Definitions of this as a specific syndrome unrelated to the menstrual cycle are given and the clinical features reviewed. During a forced water diuresis the flow and composition of the urine and the plasma volume were studied on tilting from the supine to the upright position 7 premenopausal and 4 postmenopausal patients with this disorder. No differences were found in the results obtained in the follicular and luteal phases of the menstrual cycle or in the pre- and post-menopausal patients. The reductions in urinary volume and electrolyte excretion on upright tilting were greater than those observed under similar circumstances during the luteal phase of the menstrual cycle in normal female controls, and attributed to increased proximal renal tubular reabsorption. The rate of loss of isotopically labeled albumin from the intravascular compartment was greater in patients with idiopathic edema than in control subjects. A reduction in blood volume on tilting occurred in control subjects and patients with idiopathic edema, but was greater in the latter; and the larger the fall the greater were the reductions in urinary flow and electrolyte excretion. The effect of administering 9-.alpha.-fluorohydrocortisone was studied in 9 patients with idiopathic edema. One patient failed to "escape" from the Na-retaining action of this mineralocorticoid and developed pulmonary edema; the others escaped normally. The pathophysiological disturbance in this condition is related to increased loss of fluid from the vascular compartment but the precise etiological mechanism remains unknown.