definition

Edema is a pathological accumulation of fluid in the tissue. Most often, the fluid escapes from the vascular system and collects in the interstice of the tissue, between the cells (interstitium). In addition to a circulatory disorder, the cause of edema is also a lack of protein. One speaks then of protein lack edemas. These arise due to the fact that the oncotic pressure in the capillaries is too low. Due to the lack of protein, not enough pressure can be built up to keep the fluid in the vascular system.

causes

Protein deficiency in the blood can lead to the formation of reduced protein edema. Liquid then collects outside the blood vessel system in interstitial space (cell space). If the protein content in the blood serum falls below 5 g / dl, there is a high risk of developing low-protein edema. The causes of protein deficiency in the blood (hypoproteinemia) can be numerous. On the one hand, low protein intake in the diet is responsible for this.

This is usually no problem in the Western world. In Africa, however, many, especially children, suffer from protein deficient edema, which is also called hunger edema. Protein deficiency also occurs in certain diseases. With a weakness of the pancreas (pancreatic insufficiency), the large protein molecules in the intestine can not be completely split and so can not be absorbed through the mucosa. Even in the absence of synthesis of the liver (liver cirrhosis) can lead to protein deficiency, since there from the amino acids, which are taken up with the food, usually new protein molecules are formed. In Europe, low-protein edema in the context of a tumor disease (due to increased protein consumption) is a common cause. This also applies to increased protein loss by the kidneys (nephrotic syndrome).

At which symptoms can one recognize a protein deficiency edema?

Edema is a pathological accumulation of fluid in the tissue. These can in principle occur anywhere in the body. Mostly in one of the upper layers of the skin, because here the capillaries lose fluid. These edema are then perceived externally as swelling. Another indication of a protein deficiency is a weight loss. This is usually caused by the reduction in muscle mass. The muscles are broken down to increase the protein content in the blood a little. Due to the missing musculature, the affected person often feels weak and less efficient.

Wound healing is significantly delayed because protein is also needed to build up new tissue. The immune system is weak, too. Frequent infections are the result. Other signs are dark circles and protruding bones (eg on the face). Also hair loss and brittle nails can be an indication of a lack of protein. Overall, there are numerous symptoms in which one can think of protein deficiency.

Symptoms on the stomach

Especially hunger edema show up with a buildup of water in the abdominal area. The cause of hunger edema is protein deficiency. Normally, the body needs a corresponding protein intake through the diet to maintain the protein content in the blood. Starvation leads to a lack of protein during the course of the disease. As a result, the oncotic pressure in the blood vessel system decreases and water accumulates in the intercellular space. This is also the case for hunger edema in the legs but especially on the stomach.

diagnosis

The suspicion of a protein-restricted edema can already be provided with anamnesis and a short physical examination. The doctor asks for pre-existing conditions that indicate a protein deficiency or increased protein loss. Then follows the physical examination. Edema are often eye diagnoses. Even the layman often perceives water retention in the tissue. This is followed by a blood test. The total protein content in the blood is measured. In addition, urine can also be examined as to whether there is a protein excretion in the urine.

disease

The course of the disease of low-protein edema is also dependent on its cause. If the cause of protein deficiency is not resolved in the long term, the symptoms get worse. In addition to reduced protein edema, there is also a rapid loss of muscle mass. To keep the protein content in the blood approximately constant, the body builds muscle. The longer protein deficiency edema exists, the higher the risk of complications. Through a supply of protein (through food or as an infusion) the course of the disease can usually be stopped.

Therapy of a protein deficiency edema

Low-protein edema can be treated if you manage to eliminate the cause of the edema - the protein deficiency. In a hunger edema (reduced protein intake in the diet) should be gradually increase the protein intake in order not to produce a Refeeding syndrome. This disease can arise when patients suddenly suddenly fed normal amounts of food after a long period of malnutrition. In case of weakness of the pancreas, the digestive enzymes can be administered in tablet form.

This then leads to a better protein cleavage in the intestine. Patients with end-stage liver disease are usually given protein infusions. Since a sufficient body protein formation is no longer possible. An extra dose of protein via the vein (as an infusion) can also be used to treat tumor patients. Especially if they suffer from the protein deficiency of ascites (ascites). If the protein deficiency edema develops due to protein loss in the kidney, it must try to treat the kidney disease in order to prevent further protein loss.

forecast

The prognosis of low-protein edema is very different. Protein deficiency edema is usually more of a symptom that can occur in various diseases. The prognosis then depends on the prognosis of the disease. A hunger edema can usually be treated very well, if you pay attention to a gradual increase in protein intake. Low-protein edema as part of a weakness of the pancreas can be treated with medication and have a good prognosis.

Severe liver and kidney diseases, which lead to low-protein edema, can usually only be treated poorly. Accordingly, the prognosis is bad as regards the edema. This also applies to protein deficiency edema in tumor patients. It must be said that an (intravenous) protein administration can often at least temporarily reduce edema, independently of the underlying disease.

sequelae

The consequences of protein deficiency are serious. They can range to life-threatening illnesses. The body therefore tries everything to counteract a threat of protein deficiency. Edema due to protein deficiency are therefore already a consequence of protein deficiency, which usually only occur with pronounced protein deficiency. Before that, the body is already trying to break down muscle mass. If the protein deficiency is not balanced it comes underweight. This can lead to death.


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  • internal Medicine 
  • pediatrics 
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