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Anasarca refers to a state of generalized edema.
Some definitions of anasarca focus on the presence of subcutaneous (body wall and/or extremity) edema 1,2,7, while others focus on pleural effusions and ascites 3. An overarching definition is the accumulation of fluid (water retention) in various or all tissues and body cavities, without specification of a particular body site 4-6.
Anasarca usually results from capillary filtration/leakage exceeding the amount of fluid removed via lymphatic drainage. Fluid accumulates in the interstitial spaces ("third spacing").
The causes of anasarca are various 2,6:
- nephrotic syndrome
- end-stage renal disease
- heart failure
- hypothyroidism (myxedema)
- inferior or superior vena cava obstruction
- lymphedema due to lymphatic obstruction by tumor or filariasis
- sepsis with fluid resuscitation
- hydrops fetalis
Anasarca of the body wall manifests as the following, in order of increasing severity 2:
- subcutaneous fat stranding
- pockets of fluid accumulation on the dependent subcutaneous tissues
- fluid accumulation in the intermuscular planes or non-dependent subcutaneous tissues
- circumferential or diffuse fluid collection in the subcutaneous tissues and intermuscular/tissue planes of multiple segments of the torso
History and etymology
Anasarca is an abbreviation of the Greek phrase ὕδρωψ ἀνὰ σάρκα (húdrōps anà sárka) 8, meaning dropsy throughout the flesh/body. The Greek root sarx (genitive sarkos) is also the origin of sarcoid and sarcopenia.
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- 2. Lo Gullo R, Mishra S, Lira D et al. Quantification of Interstitial Fluid on Whole Body CT: Comparison with Whole Body Autopsy. Forensic Sci Med Pathol. 2015;11(4):488-96. doi:10.1007/s12024-015-9728-y - Pubmed
- 3. Nishimura Y, Fajgenbaum D, Pierson S et al. Validated International Definition of the Thrombocytopenia, Anasarca, Fever, Reticulin Fibrosis, Renal Insufficiency, and Organomegaly Clinical Subtype (TAFRO) of Idiopathic Multicentric Castleman Disease. Am J Hematol. 2021;96(10):1241-52. doi:10.1002/ajh.26292 - Pubmed
- 4. Cubas M, Pleis L, Gomes D et al. Mapping and Definition of Terms Used by Nurses in a Hospital Specialized in Emergency and Trauma Care. Rev Enf Ref. 2017;IV Série(12):35-44. doi:10.12707/riv16067
- 5. Martínez-Quintana E, Rodríguez-González F, Cabrera-Pérez L, Martínez-Martín M. Ascites in Adult Patients With Cyanotic Congenital Heart Disease. World J Pediatr Congenit Heart Surg. 2010;2(1):97-103. doi:10.1177/2150135110384636 - Pubmed
- 6. Mandal AK. Effectiveness of Bumetanide Infusion in Treatment of Generalized Edema and Congestive Heart Failure. OJIM. 2014;04(03):73-81. doi:10.4236/ojim.2014.43012
- 7. AH Guerra A, Garro R, McCracken C, Rouster-Stevens K, Prahalad S. Predictors for Early Readmission in Patients Hospitalized with New Onset Pediatric Lupus Nephritis. Lupus. 2021;30(12):1991-7. doi:10.1177/09612033211044648 - Pubmed
- 8. Harper, D. (n.d.). Etymology of anasarca. Online Etymology Dictionary. Retrieved January 15, 2022, from https://www.etymonline.com/word/anasarca