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Internal Medicine

Epidemic dropsy

Clinical state resulting from use of edible oils adulterated with Argemone mexicana oil characterized by pitting edema of the extremities, especially of the lower limbs, cutaneous erythema and local tenderness.

Clinical state resulting from use of edible oils adulterated with Argemone mexicana oil characterized by pitting edema of the extremities, especially of the lower limbs, cutaneous erythema and local tenderness.


Clinical features

Acute manifestation of bilateral pitting edema, erythema, and local tenderness along with cardiac and respiratory problems in severe cases leading to death.

Gastroenteric features:

  • Watery diarrhoea and vomiting

Leakage of the protein-rich plasma component into the extracellular compartment:

  • Bilaterally symmetrical pitting oedema of the lower limbs
  • Marked cutaneous flush with tenderness
  • Blanching of oedematous parts on pressure
  • Burning sensations, itching and paresthesias

Cardiopulmonary symptoms:

  • Cough
  • Palpitations
  • Exertional breathlessness
  • Orthopnoea progressing to frank right-sided congestive cardiac failure

Renal features:

  • Mild to moderate anaemia
  • Hypoproteinaemia
  • Mild to moderate renal azotemia

Ocular features:

  • Retinal haemorrhages
  • Hypersecretory glaucoma

Management

There is no specific therapy.

  • Removal of the adulterated oil
  • Symptomatic treatment of congestive cardiac failure and respiratory symptoms
  • Antioxidants
  • Multivitamins

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