Idiopathic Edema Nd Hyperaldosteronuria: Postural Venous Plasma Pooling.

413 T SYNDROMES associated with edema in the absence of renal, cardiac, hepatic, pulmonary, central nervous system, or vascular disease have been described in mature women: Streeten and Conn in 1951’ reported edema of obscure origin in six women who demonstrated excessive daily weight gain, reversal of normal diurnal variation of water excretion, and inability to excrete a water load normally when erect, whereas diuresis occurred during recumbent posture. Aldosterone excretion was normal or only slightly increased. The altered water excretion in the erect position could be blocked by ethanol, by inflation of a cervical cuff to 15-30 mm Hg, and usually by sympathomimetic drugs. Erect posture after water loading in the recumbent position was associated with an increase in urine osmolality and decrease in free water clearance without alteration in glomerular filtration rate suggesting an inappropriate antidiuretic hormone effect. Clinical improvement or elimination of edema occurred during chronic administration of dextroamphetamine. A second syndrome of “idiopathic” edema differing from the first by the presence of hyperaldosteronuria has been reported in a number of women. ‘ The hyperaldosteronuria in these patients appears to be secondary, however, rather than primary; hypertension and severe potassium deficiency were not usually observed.0 The edema was sometimes cyclic relative to menses and of variable severity. In one of these patients, a