Differential diagnosis of chronic lower limb edema

Česká verzia

Authors: David Ambrož
Authors place of work: II. interní klinika kardiologie a angiologie 1. LF UK a VFN, Praha
Published in the journal: Vnitř Lék 2022; 68(3): 181-184
Category: Review Articles

Summary

Lower extremity edema is a common complaint of patients across all medical specialties. This is a wide group of conditions, ranging from relatively minor conditions such as false swelling in lipedema to life-threatening conditions such as heart failure and nephrotic syndrome. The most common cause of chronic edema is chronic venous disease. High-quality differential diagnosis aims to determine the etiology of edema and initiate targeted treatment.

Keywords:

chronic venous disease – chronic heart failure – lower limb edema – clinical signs

Zdroje

1. Vuylsteke ME, Thomis S, Guillaume G, Modliszewski ML, Weides N, Staelens I. Epidemiological study on chronic venous disease in Belgium and Luxembourg: prevalence, risk factors, and symptomatology. Eur J Vasc Endovasc Surg. 2015;49(4):432–9.

2. Špinar J et al. Summary of the 2016 ESC Guidelines on the diagnosis and treatment of acute and chronic heart failure. Prepared by the Czech Society of Cardiology, Cor et Vasa. 2016;58:e530-e568..

3. Epidemiology and Morbidity of Lymphedema. In: Greene A., Slavin S., Brorson H. (eds) Lymphedema. Springer, Cham. https://doi.org/10.1007/978-3-319-14493-1_4.

4. Richy FF, Laurent S. Effi cacy and safety profi les of manidipine compared with amlodipine: A meta‑analysis of headto‑head trials. Blood Pressure 2011; 20: 54–59.

5. Musil D. Co nového přináší aktualizace CEAP klasifikace chronického žilního onemocnění z roku 2020?; Vnitr Lek 2021, 67(3):143-148 | DOI: 10.36290/vnl.2021.035.

6. Becker M, Schilling T, von Beckerath O, Kröger K. Sonography of subcutaneous tissue cannot determine causes of lower limb edema. Vasa. 2015 Mar;44(2):122-8.

7. Theresa A McDonagh, Metra M, Adamo M et al. ESC Scientific Document Group, 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) With the special contribution of the Heart Failure Association (HFA) of the ESC, European Heart Journal, Volume 42, Issue 36, 21 September 2021, Pages 3599–3726.

8. De Maeseneer MG, Kakkos SK, Aherne T et al. Editor’s Choice – European Society for Vascular Surgery (ESVS) 2022 Clinical Practice Guidelines on the Management of Chronic Venous Disease of the Lower Limbs. Eur J Vasc Endovasc Surg. 2022 Feb;63(2):184-267. doi: 10.1016/j.ejvs.2021. 12. 024. Epub 2022 Jan 11. PMID: 35027279.

9. Shoab SS, Porter JB, Scurr JH, Coleridge‑Smith PD. Effect of oral micronized purified flavonoid fraction treatment on leukocyte adhesion molecule expression in patients with chronic venous disease: a pilot study. J Vasc Surg. 2000;31(3):456-61.

10. Jantet G. RELIEF study: first consolidated European data. Reflux assEssment and quaLity of lIfe improvement with micronized Flavonoids. Angiology. 2000 Jan;51(1):31-7.

11. Kakkos SK, Nicolaides AN. Efficacy of micronized purified flavonoid fraction (Daflon®) on improving individual symptoms, signs and quality of life in patients with chronic venous disease: a systematic review and meta‑analysis of randomized double‑blind placebo‑controlled trials. Int Angiol. 2018 Apr;37(2):143-154. doi: 10.23736/S0392-9590. 18. 03975-5. Epub 2018 Jan 31. PMID: 29385792.