Unexplained swelling symptoms in women (idiopathic oedema) comprise one component of a common polysymptomatic syndrome

• Published in: QJM : An International Journal of Medicine Vol. 97; no. 11; pp. 755 - 764
• Main Authors: Dunnigan, M.G., Henderson, J.B., Hole, D., Pelosi, A.J.
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.11.2004; Oxford Publishing Limited (England)
• Subjects: Adolescent; Adult; Affective Symptoms - complications; Aged; Aged, 80 and over; Autonomic Nervous System Diseases - complications; Biological and medical sciences; Body Mass Index; Edema - epidemiology; Edema - etiology; Edema - genetics; Female; General aspects; Humans; Logistic Models; Medical sciences; Middle Aged; Prevalence; Risk Factors; Scotland - epidemiology; Severity of Illness Index; Somatoform Disorders - complications; Syndrome; Scotland; Human; Medicine; Edema; Symptomatology; Swelling; Idiopathic; Adult; Female; Woman; Syndrome
• ISSN: 1460-2725; 1460-2393
• DOI: 10.1093/qjmed/hch126

Background: Non-menstrually-related swelling symptoms (idiopathic oedema) are common in women. The community prevalence of such symptoms, their association with other symptoms, and their underlying aetiology, are uncertain. Aim: To determine the community prevalence of swelling symptoms and the independent contributions of major risk factors. Design: Comparison of major risk factors in women with and without swelling symptoms. Methods: We assessed 196 women attending a menopause clinic, 201 women attending a fracture clinic and 201 women attending their general practitioner. Each documented family histories of swelling symptoms and diabetes mellitus, age, height and current weight. Women attending the menopause and fracture clinics also completed Visual Analogue Symptom (VAS) scales documenting the perceived severity of swelling symptoms, and of 20 affective, somatic and functional autonomic symptoms. The independent contributions of risk factors to swelling symptom risk were estimated by logistic regression analysis. Results: Of those attending a fracture clinic or their general practitioner, 28% and 33%, respectively, experienced non-menstrually-related swelling symptoms in the month before interview. Severe (RR 43, 95%CI 16–112, p < 0.001) and moderate (RR 7.8, 95%CI 4–15, p < 0.001) affective symptoms, a family history of swelling symptoms (RR 4.5, 95%CI 2.3–8.8, p < 0.001) and a body mass index (BMI) ≥25 kg/m2 (RR 4.8, 95%CI 2.5–8.9, p < 0.001) were significantly associated with the presence of mild to severe swelling symptoms (VAS 1–9). The prevalence of swelling symptoms increased from 8% in women with no risk factors to 100% in women with three risk factors, which included severe affective symptoms. Discussion: Affective symptom severity provides the principal independent contribution to swelling symptom risk. BMI ≥25 and a family history of swelling symptoms provide smaller independent contributions. The nature of the mechanisms underlying these associations remains uncertain.