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Management of idiopathic oedema

Idiopathic oedema is well recognised in the USA and on the continent of Europe but is less commonly diagnosed in Britain. It occurs predominantly in women, the age of onset usually being between 20–40 years. In most patients symptoms consist of periodic ankle swelling and abdominal distension and sometimes swelling of the hands and face. Severely affected patients may develop pulmonary congestion or hypovolaemia. Symptoms are often worse premenstrually, in a warm environment and after prolonged standing, and are associated with headache, irritability and depression. The cause of idiopathic oedema is not known, but it is probably related to an excessive loss of fluid from the blood vessels that occurs when the patient is upright.1 Cardiac, hepatic, renal, allergic, nutritional and hyproprotein-aemic disease must be excluded.2 3