Anasarca

What is anasarca?

Anasarca is generalized edema (swelling). This is a severe buildup of fluid in the tissues of several parts of your body, like your face, belly, genital areas, lungs and limbs. Anasarca happens when something throws off the balance of fluids moving between your blood vessels and the tissues around them. You may have too much fluid leaving your capillaries and going into nearby tissue. Or you may have lymphatic drains that aren’t removing enough fluid to keep the balance.

This imbalance can be similar to your lawn after a heavy rain. The soil can’t hold all the water, so the water rises above the soil. When your blood vessels aren’t holding the fluids they’re supposed to, the fluids flood nearby tissues and make them swell.

With this much water retention, you may notice that your rings fit more tightly or it’s hard to put on your shoes. Unlike ordinary swelling, anasarca causes these kinds of issues in multiple places in your body.

What are the symptoms?

Anasarca symptoms include:

• Noticeable swelling and puffiness in several parts of your body. Skin in these areas may look stretched or shiny.
• Higher-than-normal body weight (increase in weight) from excess fluid.
• Limited arm and leg movement due to swelling.
• Ascites (fluid buildup in your belly).
• Fatigue.
• Pulmonary edema (fluid buildup in your lungs).
• Low urine (pee) output (oliguria) or no pee (anuria).

What causes anasarca?

Anasarca causes begin in your heart, liver or kidneys. You can also develop anasarca after surgery.

Conditions that cause anasarca include:

• Heart failure.
• Glomerulonephritis (a kidney disease).
• Nephrotic syndrome (a kidney issue).
• Cirrhosis of the liver.
• Kidney failure.
• Liver failure.
• Medications like some steroid hormones and blood pressure medicines (antihypertensives).
• Malnutrition (eating foods that are very low in calories and protein for an extended time).
• Inflammatory conditions like rheumatoid arthritis (RA).
• Lymphatic system issues.
• Certain GI diseases, like celiac disease.
• Hypothyroidism.
• Infections.
• Allergic reactions.

What are the complications of anasarca?

Complications of anasarca may include:

• Skin ulcers or infections like cellulitis.
• Deep vein thrombosis.
• Pericardial effusion.
• Acute respiratory distress syndrome.
• Organs not working well.

How is anasarca diagnosed?

A provider will ask about your medical history and what medicines you take. They’ll ask you how long you’ve had symptoms and if you’ve had them before. They’ll also perform a physical exam. Sometimes, your body position (like elevating your legs) helps with the swelling. And if a provider presses on your skin, it may make a temporary dimple. These kinds of details can help your provider find the cause of anasarca.

What tests will be done to diagnose anasarca?

Providers can diagnose anasarca with lab tests and imaging, like:

• Blood tests.
• Urinalysis.
• Chest X-ray.
• Echocardiogram (Echo).
• Computed tomography (CT) scan.
• Ultrasound of your legs or kidneys.
• Magnetic resonance imaging (MRI).
• Lymphoscintigraphy (nuclear medicine imaging for your lymphatic system).

How is anasarca treated?

Anasarca treatment involves managing the condition that causes it.

Treatment for anasarca often includes taking diuretics. People sometimes call them “water pills.” These medicines help your body move excess salt and water into your urine (pee) so you can get them out of your body. Diuretics make you pee more often, especially in the first few hours after taking them. But they can cause dehydration, high potassium (hyperkalemia) or high LDL (“bad”) cholesterol (hypercholesterolemia) in some people.

Depending on the cause of anasarca, other treatments may include:

• Limiting how much fluid and salt you consume.
• Adding certain nutrients to your meal plans.
• Albumin infusions through an IV in your arm.
• Dialysis.
• Compression therapy (stockings or wraps you wear).
• Elevating your legs.
• Lymphatic drainage massage.

Can this be prevented?

Yes, you can prevent anasarca by managing the conditions that can cause it. Follow your provider’s instructions for changing daily habits or taking medications correctly.

What can I expect if I have anasarca?

The outlook for anasarca is different from person to person depending on the cause and how quickly the treatment works. If treatment is successful, your provider can reverse anasarca. The outlook is good for people who get anasarca from medication or an infection. The prognosis isn’t as good for people who get anasarca because of a long-term condition.

How do I take care of myself?

In addition to taking prescribed medications, you can:

• Elevate your legs.
• Get regular physical activity like walking.
• Wear compression stockings.
• Avoid consuming too much salt.

When should I see my healthcare provider?

Contact your provider if you have swelling in several parts of your body, especially if you have shortness of breath. These are signs of heart failure.

What questions should I ask my doctor?

Questions to consider asking your provider may include:

• What’s causing this swelling?
• What’s the best treatment for me?
• How can I reduce the amount of salt in the meals I eat?
• How often should I wear compression stockings?

A note from Cleveland Clinic

You may have had some swelling before. But the severe swelling you get with anasarca means there’s something more serious going on. This is not only uncomfortable but limits how much you can move around. The sooner you contact your provider, the sooner you can learn the cause and get some relief. Providing details about your symptoms helps your provider find out what’s causing them.