Hypervolemia is also known as “fluid overload” and occurs when the body retains more water than it needs. One of the characteristics of hypervolemia is pitting edema on the parts of the body that have a lot of tissue to hold fluids and the legs due to gravity pulling the fluid down. Intravenous Fluids – If intravenous fluids are given at too fast a rate, hypervolemia can develop.
Kidney Disease – Kidneys that are not functioning well are unable to excrete the proper amount of fluids. Heart Disease – This happens when the heart becomes weakened and can no longer pump proper amounts of fluid through the body. Good foods that can help season foods are; lemon juice, lime juice, lemon pepper, herbs and spices that do not contain salt. Doctors may prescribe a “water-pill” or diuretic which helps the body to pull off excess fluid.
Stasis dermatitis (also called venous stasis dermatitis) is an inflammatory reaction seen in the skin of the lower leg caused by static (slow or delayed) venous flow of the leg.
The symptoms of stasis dermatitis vary with the general health of the patient, duration of the condition and status of treatment. If left untreated, stasis dermatitis will continue to the final stage where the skin ulcerates due to the back pressure caused by venous incompentency.
Factors that can contribute to the early onset of stasis dermatitis include obesity, inactivity, venous injury, dependency (lower than the heart) of the leg and infection of the leg. Central to the treatment of venous stasis dermatitis and venous stasis ulcers is control of lower extremity edema due to venous hypertension. Eczematous changes (peeling and flaking) and lichenification (hardening of the epidermis) can be treated with skin softening agents. All Natural Antifungal Healing Foot Cream soothes dry peeling skin and treats fungal infections of the foot with a therapeutic formula of tea tree oil and lavender oil. Therafirm Compression Knee High Socks are light-weight, fashionable graduated compression stockings designed for both men and women. Natural Lavender Tea Tree Lotion soothes dry skin and treats fungal infections of the foot. Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) is a rare clinical syndrome, commonly seen in elderly patients who present with dorsal pitting edema of the hands and has a dramatic response to steroids, suggesting a benign nature. Elderly patients presenting with musculoskeletal symptoms such as painful, swollen or stiff jointsare challenging to physicians. An 83 year old man, with a history of chronic leg ulcers and poor mobility presented following a fall at home.
Inspection of his hands revealed bilateral, symmetrical swelling, involving all the fingers and more pronounced on the dorsum. Blood tests during this admission showed normocytic anaemia with low vitamin B12 levels but normal ferritin. In view of the clinical presentation and seronegativity, a diagnosis of peritendinous rheumatoid arthritis was considered.
Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome was first described by McCarty et al in 1985 1 . It predominantly affects elderly males and although not exceptionally rare, there is no clear documentation of the incidence of this condition (2). Although generally thought to be a characteristic benign syndrome with good outcomes, several studies have been published linking RS3PE to various rheumatic disorders such as spondyloathropathies, psoriasis (HLA associations), polymyalgia rheumatica, and temporal arteritis.
Although MRI scanning offers the best imaging technique to diagnose the condition.,RS3PE is a clinical diagnosis.


RS3PE should be considered as a diagnosis when a patient presents with bilateral symmetrical pitting oedema of the hands and or feet, and is found to be seronegative. A high index of suspicion is needed to search for underlying malignancy especially in the absence of associated rheumatic disorders and poor response to corticosteroid therapy. Mehmet Sayarlioglu Remitting Seronegative Symmetrical Synovitis with Pitting Edema (RS3PE) Syndrome and Malignancy.
The above article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. The process of excreting excess water is mostly controlled by the kidneys and certain disorders can disrupt this mechanism and cause fluids to disperse into the tissues of the body. Too much sodium increases the fluids in the body and too little sodium decreases the fluids in the body.
It cannot effectively pump out all of the excess and the fluids begin to remain in the tissues of the body.
This can happen from short term illness, injury or surgery and can also be due to long-term health conditions. Fluids need to be given at a rate that the heart can keep up with to maintain fluid balance.
People with hypervolemia due to kidney disease, usually require kidney dialysis in which a machine pulls of the excess fluid. It is important to follow your doctor’s instructions with these and eat foods high in potassium.
The primary contributing cause of stasis dermatitis is valvular incompentency of the veins of the leg resulting in chronic edema (swelling). Edema can be controlled by elevating the legs above the level of the heart, use of diuretics and the use of compression hose.
Inflammatory changes of the skin are common and can be treated with topical or oral steroids.
The area superficial to the origin of the great saphenous vein is the most common site of ulceration. We recommend using Onox Foot Solution daily to control excessive foot perspiration and foot odor. Sometimes it is associated with other rheumatologic conditions and potential underlying malignancy should be ruled out, especially when there is a poor response to steroids.
The common conditions encountered are osteoarthritis, crystal arthropathies, spondyloarthropathies and rarely seropositive arthritis. On palpation there was pitting oedema over the dorsum without signs of synovitis or joint deformity.(Figure 1 and 2). It responds dramatically to corticosteroids with long term remission after withdrawal, suggesting a benign prognosis.
3 It may also be a paraneoplastic manifestation of haematological or solid malignancies 4 (eg.
Remitting seronegative symmetrical synovitis with pitting edema (RS3PE): a form of paraneoplastic polyarthritis? Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome: ultrasonography as a diagnostic tool.
Normal sodium intake will not cause hypervolemia, however certain conditions cause the sodium levels to rise too high causing fluid retention or hypervolemia. Places this is found are the; lower legs and ankles, hands and arms, abdomen and in severe cases, the lungs.
Also, most intravenous fluids contain 0.9% Sodium Chloride which can keep the fluids from filtering through the kidneys at the proper rate.


This type of hypervolemia sometimes requires a procedure to extract the excess fluid from the abdomen with a needle.
Keeping a journal of daily weights over a week can help your doctor decide if you have hypervolemia. At home, the doctor may only let you have up to 2 liters a day of fluids or less depending on the amount of swelling. Lichenification describes crusting and layering of the skin that occurs when the normal exfoliative properties of the skin are disrupted by chronic swelling. It's important to realize that when using compression hose, the hose need to be put on first thing in the morning in advance of any swelling. We recommend using Onox daily to control excessive perspiration, athlete's foot and foot odor.
RS3PE highlights a different inflammatory disease involving the tenosynovium of the tendons of the hands with a characteristic presentation. This was of sudden onset, initially on the right hand and gradually progressed until the time of admission when it became prominent over the dorsum of both hands. An alternative imaging technique for identification of extensor tenosynovitis is ultrasonography.
If liver disease becomes too advanced, the patient may also require dialysis due to kidneys being overworked. Good foods that contain potassium are; Bananas, oranges and orange juice, baked potato with skin, strawberries and over-the-counter salt substitute.
Pigmentation changes (darkening) of the leg usually follows a prolonged period of swelling (edema) of the lower leg. In this stage of stasis dermatitis, oozing, scaling and deep pigmentation changes in the skin may become apparent. Discoloration or darkening of the skin is often due to the deposition of hemosiderin (the iron component of red blood cells). This case details such a presentation and aims to raise awareness amongst general physicians. Both hands were initially tender, but painfree at rest, and restricted in movement due to the swelling. Review of these cases suggested that RS3PE associated with neoplasia was associated with a poor response to steroid treatment.
Mild episodes of hypervolemia may be able to be managed at home, but often more severe cases need to be managed in the hospital.
Once hemosiderin is deposited in the skin, is is much like a tattoo that stains the skin from within. Lately he had also noticed mild inactivity stiffness in his knees and shoulders, He had no previous musculoskeletal history, no skin rash or trauma to his hands. Computerised tomography (CT) of the chest and abdomen did not show any evidence of malignancy. If your doctor gives the okay for alternative home remedies there are many safe home remedies that can help reduce the fluid excess right at home.



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