Idiopathic Cyclic Edema

Aka: Idiopathic Cyclic Edema, Idiopathic Edema

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II. Associated Conditions

  1. Premenstrual Syndrome

III. Epidemiology

  1. Affects young women most commonly

IV. Pathophysiology

  1. No underlying systemic cause
  2. Related factors
    1. Increased capillary permeability
    2. Renin-Angiotensin-Aldosterone activation

V. Associated conditions

  1. Obesity
  2. Diabetes Mellitus
  3. Hypothyroidism

VI. Signs

  1. No association with Menstrual Cycle
  2. Orthostatic Edema
    1. Water retention while upright
    2. Diuresis while supine
    3. Body weight increases >2 kg with edema

VII. Differential Diagnosis: Estrogen stimulated edema

  1. Increased Estrogen with Sodium and water retention
  2. Cyclic edema related to Menses
    1. Weight gain on edematous days: 1.5 to 2.5 kg
    2. Lower extremity Pitting Edema
  3. Diuresis follows Menses
    1. Orthostasis may occur with diuresis

VIII. Management

  1. Avoid Diuretics (worsens edema)
  2. Restrict salt intake
  3. Consider ACE Inhibitor

IX. References

  1. Brenner and Rector (2000) Kidney, Saunders, p. 845-6

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