Pedal edema causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: M.Umer Tariq [2]; Mugilan Poongkunran M.B.B.S


Pedal edema can be either pitting or non pitting. Peripheral pitting edema in which an indentation remains after pressure is released, is the more common type of peripheral edema, and results from water retention. It can be caused by systemic diseases, pregnancy in some women, heart failure, or local conditions such as varicose veins, thrombophlebitis, insect bites, and dermatitis. Non-pitting edema is observed when the indentation does not persist. It is associated with lymphedema, lipedema and myxedema. Edema caused by malnutrition defines kwashiorkor, an acute form of childhood protein-energy malnutrition characterized by edema, irritability, anorexia, ulcerating dermatoses, and an enlarged liver with fatty infiltrates.


Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

Common Causes

Causes by Organ System

Cardiovascular Aneurysm, AV fistula, cardiac valvular dysplasia, cardiofaciocutaneous syndrome, cardiomyopathies, chronic constrictive pericarditis, chronic right sided heart failure, chronic venous insufficiency, congenital heart disease, congenital mitral malformation, congenital mitral stenosis, congestive heart failure, constrictive pericarditis, cor pulmonale, coronary heart disease, deep vein thrombosis, dilated cardiomyopathy, Henoch-Schönlein purpura, hereditary congenital lymphedema, hypertensive heart disease, infective endocarditis, left heart failure, left-sided valvular disease, lymphatic obstruction, lymphedema, lymphedema tarda, lymphedema-distichiasis syndrome, lymphoedema praecox, May-Thurner syndrome, Milroy's disease, myocardial Infarction, Noonan syndrome, Norgestrel and Ethinyl estradiol, pericardial effusion, pericarditis, peripheral vascular disease, phlegmasia alba dolens, portal hypertension, primary lymphedema, pulmonary stenosis, sub-pulmonary stenosis, thrombophlebitis, thrombosis, tricuspid regurgitation, tricuspid stenosis, varicose veins, vasculitis, venous obstruction, venous thrombosis, venous ulcer, yellow nail syndrome, Young Simpson syndrome
Chemical / poisoning Carbon monoxide, bee sting, envenomation, insect bites, metabolic poisons, mushroom poisoning, snake venoms, snakebites, wasp
Dermatologic Carbuncle, cellulitis, contact dermatitis, contusion, eosinophilic fasciitis, erysipelas, gas gangrene, Henoch-Schönlein purpura, Kawasaki disease, kerion, psoriatic arthritis, rocky mountain spotted fever, sarcoidosis, scleroderma
Drug Side Effect Acetaminophen, ACE inhibitors, aceon, actos, aldomet, amiodarone, amlodipine, Amlodipine and Benazepril, Amlodipine besylate and Valsartan, amoxicillin-clavulanate, angiotensin II receptor blockers, antihistamines, arixtra, aspirin, atorvastatin, avandia, beta blockers,Bosutinib, calcium channel blockers, carbamazepine, carbenoxolone, cardura, casodex, Cefpodoxime, chlorpromazine, cilostazol, cisplatin, clopidogrel, colchicine, conivaptan, coreg, crestor, cyclophosphamide, dacarbazine, danazol, Denileukin diftitox, deserpidine, diltiazem, diflunisal, docetaxel, Enzalutamide, Eribulin, estrogen, Etonogestrel, evista, febuxostat, felodipine, flecainide, fludrocortisone, fondaparinux, gabapentin, Gemcitabine, glitazones, Goserelin, guanethidine, halothane, herceptin, hormonal contraceptives, hydralazine, Ibrutinib, ibuprofen, imatinib mesylate, indomethacin, intrathecal baclofen, isoniazid, isradipine, Ketorolac tromethamine, labetalol, lamotrigine, leflunomide, lipitor, lithium, malignant hyperthermia, Medroxyprogesterone, Megestrol, Meloxicam, methadone, methylprednisolone, methysergide, Mifepristone, minipress, minoxidil, miltefosine, Meprobamate, motrin, naltrexone, Naproxen sodium, Naproxen and esomeprazole magnesium, neuroleptic malignant syndrome, Niacin, nicardipine, nifedipine, nitrendipine, nitrofurantoin, non-depolarizing muscle blocking agents, nonsteroidal anti-inflammatory drugs, norpace, norvasc, Olanzapine, Olsalazine, Oprelvekin, phenylbutazone, phenytoin, pinacidil, pindolol, pioglitazone, Piroxicam, plendil, pramipexole, propylthiouracil, Radium chloride, Rasagiline, repaglinide, reserpine, riociguat,rofecoxib, ropinirole, roxithromycin, Sargramostim, saxagliptin, selective serotonin reuptake inhibitors, statins, Sunitinib, tamoxifen, taxol, tazarotene, temsirolimus, tenormin, thiazolidinedione, tocilizumab, Trametinib dimethyl sulfoxide, tretinoin, univasc, valproic acid, vasodilators, verapamil, vytorin, Thalidomide, xeloda, zidovudine, zonisamide
Ear Nose Throat Alport syndrome
Endocrine Acromegaly, Addison's disease, Cushing's syndrome, diabetes, diabetic ketoacidosis, hormonal contraceptives, hyperthyroidism, hypothyroidism, mitochondrial disease, myxoedema, ovarian hyperstimulation syndrome, POEMS syndrome,

Young Simpson syndrome

Environmental Bee sting, envenomation, frostbite, insect bites, mushroom poisoning, sunburn, wasp
Gastroenterologic Alagille syndrome, alcohol abuse, alpha 1-antitrypsin deficiency, arginosuccinate synthetase deficiency, autoimmune hepatitis, biliary atresia, carcinoid tumours and carcinoid syndrome, celiac disease, cirrhosis, crohn's disease, exudative enteropathy, galactosemia, giardiasis, haemochromatosis, hemophagocytic lymphohistiocytosis, Hennekam syndrome, hepatic failure, hepatitis B virus, hepatitis C virus, hepatotoxicity, hereditary tyrosinemia type 1, hypertrophic gastritis, inflammatory bowel disease, intestinal lymphangiectasia, liver failure, malabsorption syndrome, milk protein allergy, Ménétrier's disease, non-alcoholic steatosis, portal hypertension, protein losing enteropathy, Wilson disease
Genetic Alagille syndrome, alpha 1-antitrypsin deficiency, Alport syndrome, anti-glomerular basement membrane (anti-GBM) disease, arginosuccinate synthetase deficiency, biliary atresia, C1 esterase inhibitor (C1-INH) deficiency, cardiac valvular dysplasia, cardiofaciocutaneous syndrome, congenital heart disease, congenital mitral malformation, congenital mitral stenosis, cystic fibrosis, Dana syndrome, galactosemia, haemochromatosis, haemolytic disease of the newborn, hemophagocytic lymphohistiocytosis, Hennekam syndrome, Henoch-Schönlein purpura, hereditary angioedema, hereditary congenital lymphedema, hereditary fructose intolerance, hereditary tyrosinemia type 1, inherited hemolytic-uremic syndrome , lymphoedema-distichiasis syndrome, Milroy's disease, mitochondrial disease, Niemann-Pick disease, Noonan syndrome, ornithine transcarbamylase deficiency, POEMS syndrome, Turner syndrome, Young Simpson syndrome
Hematologic Anemia, capillary leak syndrome, haemochromatosis, hemolytic disease of the newborn, hemophagocytic lymphohistiocytosis, hyperviscosity, hypoalbuminemia, Klippel Trenaunay Weber syndrome, microscopic polyangiitis, myeloproliferative disorders, POEMS syndrome, polycythemia, sickle cell disease, sickle cell trait
Iatrogenic Bed rest, childbirth, coronary artery bypass surgery, fluid overload, psoralen plus ultraviolet A (PUVA) photochemotherapy, radiotherapy, surgery, surgical recovery, venous catheters
Infectious Disease Acanthocheilonemiasis, cellulitis, chagas disease, chronic constrictive pericarditis, chronic hepatitis B, chronic hepatitis C, epidemic dropsy, falciparum malaria, gas gangrene, giardiasis, human immunodeficiency virus (HIV), infected cut, infective endocarditis, intestinal lymphangiectasia, lupus nephritis, lymphangitis carcinomatosa, lymphatic filariasis, osteomyelitis, post-streptococcal glomerulonephritis, rocky mountain spotted fever, septicemia, sleeping sickness (East African), sleeping sickness (West African), thrombophlebitis, trichinosis
Musculoskeletal / Ortho Acromegaly, cardiofaciocutaneous syndrome, dermatomyositis, eosinophilic fasciitis, fracture, gas gangrene, gout, juvenile rheumatoid arthritis, Klippel Trenaunay Weber syndrome, Kohler disease, ligamentous sprain, metabolic myopathies, osteomyelitis, psoriatic arthritis, reflex sympathetic osteodystrophy, rheumatoid disease, rocky mountain spotted fever, rupture of popliteal cyst, systemic lupus erythematosus (SLE), Turner syndrome
Neurologic Burning feet syndrome, carcinoid tumours and carcinoid syndrome, Dana syndrome, delirium tremens, eclampsia, grand mal seizures, Hennekam syndrome, mitochondrial disease, reflex sympathetic osteodystrophy
Nutritional / Metabolic Acquired C1-esterase inhibitor deficiency, arginosuccinate synthetase deficiency, delirium tremens, galactosemia, gout, hereditary fructose intolerance, hypoalbuminemia, hypocalcemia, hypokalemia, hyponatremia, hypophosphatemia, kwashiorkor, malabsorption syndrome, malnutrition, metabolic myopathies, milk protein allergy, Niemann-Pick disease, ornithine transcarbamylase deficiency, protein losing enteropathy, refeeding edema, starvation edema, thiamine (Vitamin B1) deficiency, vitamin E deficiency
Obstetric/Gynecologic Amniotic band syndrome, eclampsia, ovarian hyperstimulation syndrome, peripartum cardiomyopathy, preeclampsia, pregnancy, premenstrual syndrome
Oncologic Carcinoid tumours and carcinoid syndrome, lymphangitis carcinomatosa, malignancies, myeloproliferative disorders
Opthalmologic No underlying causes
Overdose / Toxicity Amphetamine, cocaine, D-lysergic acid diethylamide (LSD), diazoxide, gold salts, heroin
Psychiatric Anorexia nervosa, bulimia nervosa, burning feet syndrome, psychotic agitation, refeeding edema
Pulmonary Alpha 1-Antitrypsin Deficiency, Alport syndrome, anti-glomerular basement membrane (anti-GBM) disease, cystic fibrosis, idiopathic pulmonary hypertension, pulmonary hypertension, pulmonary hypoxic hypertension, pulmonary thromboembolic hypertension, sarcoidosis, Wegener's granulomatosis, yellow nail syndrome
Renal / Electrolyte Acute glomerulonephritis, acute renal failure, anti-glomerular basement membrane (anti-GBM) disease, Bartter's Syndrome, chronic renal failure, idiopathic minimal change nephrotic syndrome, IgG4–related systemic disease, immunoglobulinic amyloidosis, inherited hemolytic uremic syndrome, nephrotic syndrome, post-streptococcal glomerulonephritis, renal cell carcinoma, Wegener's granulomatosis
Rheum / Immune / Allergy Acquired angioedema, acute phase reaction, anaphylaxis, autoimmune hepatitis, C1 esterase inhibitor (C1-INH) deficiency, cow milk protein sensitivity, dermatomyositis, eosinophilic fasciitis, hereditary angioedema, hypertrophic gastritis, IgG4–related systemic disease, inflammatory bowel disease, inherited hemolytic uremic syndrome, juvenile rheumatoid arthritis, Kawasaki disease, microscopic polyangiitis, Ménétrier's disease, rheumatoid disease, sarcoidosis, scleroderma, systemic lupus erythematosus (SLE), Wegener's granulomatosis
Sexual Turner Syndrome
Trauma Burns, crush syndrome, electric shock, foot sprain, foot ulcer, fracture of bone, infected cut, kerion, leg trauma
Urologic No underlying causes
Miscellaneous Air travel, alcohol abuse, burns, electric shock, exercise, idiopathic, immunoglobulinic amyloidosis, near drowning/hypothermia, obesity

Causes in Alphabetical Order


  1. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77ISBN 1591032016
  2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X

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