An Empirical Case of Chinese Medicine in the Treatment of Idiopathic Edema

Idiopathic edema is a common, challenging, and complicated clinical condition with no recognized cause that is easy to prolong and repeat. Professor Li has a lot of expertise treating this condition. This condition is associated with a yang shortage in the spleen and kidneys, as well as a mutual accumulation of water and blood stasis. Zhenwu Decoction and Guizhi Fuling tablet are added to the prescription. Ms. Li’s clinical experience in the treatment of idiopathic edema is being shared with the fellow.

A case of idiopathic edema after opioid abuse cessation: can failed aldosterone escape be implicated?

Edema is a recognized complication of ongoing heavy opioid use, regardless of the means of delivery or the specifics of the drug in question. The mechanism responsible remains incompletely understood. Hypotheses currently offered include increased Anti-Diuretic Hormone (ADH) secretion, histamine-mediated permeability changes, independent opioid-receptor mediated fluid retention and an exacerbation of pre-existing vascular compromise. Authors report a case of a 39yr old lady in whom edema emerged 7 months after cessation of opioid abuse. All secondary causes of edema were excluded by an exhaustive battery of investigations. The edema failed to recede with loop diuretics, and resolved only on institution of spironolactone, on which she maintained improvement. This case study reinforces hypotheses of ADH likely mediating opioid associated edema and suggests that aldosterone receptor antagonists are probably a superior class of drugs in opioid-associated edema. It also suggests that the physiological changes caused by opioid use that are responsible for edema are likely stable and persist well beyond the period of actual use. Reformed opioid abusers who never received OST are a huge population whose unique physiological status is likely to yield valuable insights into not just the pathology of opioid-abuse related edema, but the pathology of opioid use as a whole.

Late-onset pubic-phallic idiopathic edema in premature recovering infants

ObjectiveSeveral cases of isolated localized edema of the genital area in extremely low birth weight (ELBW) infants within the last 5 years prompted a search for possible explanations and a search of the literature.Study designA retrospective chart review of all cases of localized genital area edema in our 16-bed community level-3 neonatal intensive care unit (NICU) between January 2007 and December 2017.ResultsA total of six patients with localized edema of the genital area were found. Among the six cases, five provided descriptions of time of onset. Only one case had a plausible etiology [inguinal hernia (IH)].ConclusionsTo our knowledge, this entity is not well described in the literature. Etiologies are speculative. Prolonged observation in the NICU by virtue of ELBW-status suggests that there are no detrimental effects, the condition does not appear to preclude discharge and cautious expectant management and reassurance are therefore in order.