Oedema is a common childhood problem with important public health implications. It is an abnormal accumulation of fluid in the interstitial space which might result from a decrease in intravascular oncotic pressure, an increase in intravascular hydrostatic pres sure, an increase in capillary permeability or impaired lymphatic drainage. Renal sodium retention is an important factor in gener alised oedema. This article reviews the pathophysiology and aetiology of oedema in children and suggests an approach to evalu ation, diagnosis and management of the problem.
Akers D.L. Jr, Creado B. and Hewitt R.L. (1996). Iliac vein compression syndrome: case report and review of the literature. J Vasc Surg, 24, 477-481
2.
Bardare M., Falcini F., Cate R.H., Savolainen A. and Cimaz R. (1997). Idiopathic limb edema in children with chronic arthritis: a multicenter report of 12 cases. J Rheumatol; 24, 384-388
3.
Braunwald E. (1998). Edema. In: Harrison's Principles of Internal Medicine, pp. 210-214 (A S Fauci, E Braunwald, K J Isselbacher , J D Wilson, J B Martin, D L Kasper, S L Hauser and D L Longo ). New York: McGraw-Hill
4.
Ciarallo L. (2000). Edema. In: Textbook of Pediatric Emergency Medicine, pp. 223-225 (G R Feisher and S Ludwig). Philadelphia : Lippincott Williams and Wilkins
5.
Delaney V. and Adler S. (1992). Edema. In: Medicine for the Practicing Physician, pp. 1216-1221 (J.W. Hurst J W). Boston: Butterworth-Heinemann
6.
Dixon B.S. and Berl T. (1992). Pathogenesis of edema in renal disease. In: Pediatric Kidney Disease, pp. 565-577 ( C.M. Jr Edelman, J. Bernstein, S.R. Meadow, A. Spitz and L.B. Travis). Boston: Little, Brown and Company
7.
Donckerwolcke R.A. and Vande Walle J.G. (1997). Pathogenesis of edema formation in the nephrotic syndrome. Kidney Int; 51 (S58), S72-S74
8.
Dunnigan M.G. and Pelosi A.J. (1993). Familial idiopathic oedema in prepubertal children: a new syndrome. QJM; 86, 301-313
9.
Ehrich J.H. and Wurster U. (1991). Differentiation of proteinurias with electrophoresis . Pediatr Nephrol; 5, 376-378
10.
Epstein M. (1994). Edematous states. In: Internal Medicine, pp. 2670-2678 (J H Stein). St Louis: Mosby
11.
George D.E. (1984). Chronic diarrhea in infants and children. Am Fam Physician; 25, 280-288
12.
Golden M.H. (1982). Protein deficiency, energy deficiency, and the oedema of malnutrition. Lancet, i, 1263-1265
13.
Gonggryp L.A. and Todd G. (1998). Acute hemorrhagic edema of childhood (AHE). Pediatr Dermatol, 15, 91-96
Haycock G.B. (1998). Edema. In: Pediatric Nephrology , pp. 147-153 (T M Barratt, EDAvner and W E Harmon). Baltimore: Lippincott Williams and Wilkins
16.
Hisano S., Hahn S., Kuemmerle N.B., Chan J.C. and De Santo N.G. (1997). Edema in childhood. Kidney lnt ; 51(S59), S100-S104
17.
Klein S. (2000). Protein-energy malnutrition. In: Cecil Textbook of Medicine, pp.1148-1152 (L Gold-man and J C Bennett). Philadelphia : WB Saunders Company
18.
Krause I., Lazarov A., Rachmel A., Grunwald M.M., Metzker A., Garty B.Z., Halevy S. and Nitzan M. (1996). Acute haemorrhagic oedema of infancy, a benign variant of leucocytoclastic vasculitis. Acta Paediatr, 85,114-117Leung A.K. (1998). Food allergy: a clinical approach. Adv Pediatr, 45,145-177
19.
Leung A.K. and Hegde H.R. (1989). Exercise-induced angioedema and asthma. Am J Sports Med; 17,442-443
20.
Leung A.K. and Robson W.L. (1996). Evaluating the child with chronic diarrhea. Am Fam Physician; 53, 635-643
21.
Leung A.K. and Robson W.L. (2000). Evaluating the child with proteinuria. J Roy Soc Health; 120(1), 16-22
22.
Mclean R.H. (1997). Edema. In: Primary Pediatric Care , pp. 932-935 (R A Hoekelman). St Louis: Mosby
23.
O'Brien P.M., Selby C. and Symonds E.M. (1980). Progesterone, fluid, and electrolytes in premenstrual syndrome. BAMJ; 280,1161-1163
24.
Robson W.L., Leung A.K., Putnins R.E. and Boag G.S. (1990). Genital edema in children on continuous ambulatory peritoneal dialysis. Child Nephrol Urol;10, 205-210
25.
Robson W.L. and Leung A.K. (1992). Post-streptococcal glomerulonephritis. Can Fam Physician; 38, 2883-2887
26.
Robson W.L. and Leung A.K. (1993). Nephrotic syndrome in childhood. Adv Pediatr, 40, 287-323
27.
Robson W.L. and Leung A.K. (1994). Henoch-Schönlein purpura. Adv Pediatr, 4, 163-194
28.
Robson W.L. and Leung A.K. (1995). Henoch-Schönlein purpura with thoraco-lumbar spine involvement precipitated by trampoline jumping. Indian J Pediatr , 62, 733-736
29.
Schobel H.P., Fischer T., Heuzer K., Geiger N. and Schmieder R.E. (1996). Preeclampsia - a state of sympathetic overactivity . N Engl J Med; 335,1480-1485
30.
Schrier R.W. (1988). Pathogenesis of sodium and water retention in high-output and low-output cardiac failure, nephrotic syndrome, cirrhosis, and pregnancyN Engl J Med; 319,1065-1072
31.
Sevigny G.M. and Mathes B.M. (1999). Peri-orbital edema as the presenting sign of juvenile dermatomyositis. Pediatr Dermatol; 16, 43-45
32.
Smith GA, Sharma V., Knapp J.F. and Shields B.J. (1998). The summer penile syndrome: seasonal acute hypersensitivity reaction caused by chigger bites on the penis. Pediatr Emerg Care,14,116-118
33.
Spittell J.A. Jr and Schirger A. (1985). Edema, peripheral. In: Difficult Diagnosis, pp. 130-137 ( R B Taylor). Philadelphia: WB Saunders Company
34.
Starling E.H. (1895). On the absorption of fluids from the connective tissue spaces. J Physiol; 19, 312-326
35.
Torún B. and Chew F. (1994). Protein-energy malnutrition. In: Modern Nutrition in Health and Disease, pp. 950-976 ( M E Shills, J A Olson and M Shike). Philadelphia: Lea and Febiger
36.
Tulassay T., Rascher W. and Schärer K. (1989). Intra- and extrarenal factors of oedema formation in the nephrotic syndrome. Pediatr Nephrol; 3,92-100
37.
Tunnessen W.W. Jr (1999). Edema. In: Signs and Symptoms in Pediatrics, pp. 73-87 (W W Jr Tunnessen). Philadalphia: Lippincott Williams and Wilkins
38.
Túri S., Nagy J., Haszon I., Havass Z., Nemeth M. and Bereczki C. (1989). Plasma factors influencing PGI2-like activity in patients with IgA nephropathy and Henoch-Schönlein nephritis. Pediatr Nephrol; 3, 61-67
39.
Vande Walle J.G., Donckerwolcke R.A. and Koomans H.A. (1999). Pathophysiology of edema formation in children with nephrotic syndrome not due to minimal change disease. J Am Soc Nephrol; 10, 323-331
