Role of endocrinological factors in the pathogenesis of idiopathic edema

In order to investigate the etiology of idiopathic edema, clinical findings and endocrinological abnormalities were analyzed in twenty-seven patients, and the following results were obtained. An easy occurrence of subcutaneous bleeding and positive Rumpel-Leede phenomenon were observed in the majority of the patients. ADH, plasma renin activity and plasma aldosterone concentration in the patients did not show abnormalities following water loading in the supine position when compared with normal controls. But the results obtained in the present study suggested that they might contribute to water and sodium retention in the upright position. In the patients, plasma prolactin levels were not decreased, but rather increased and urinary excretion of kallikrein and kinin was reduced significantly after water loading in the upright position. Thus, prolactin and urinary kallikrein-kinin system might also contribute to water and sodium retention in idiopathic edema, directly or indirectly through the augmentation of the action of ADH and of aldosterone. It was concluded that the increased vascular permeability and endocrinological polyfactors play a role, in a cooperative fashion, in the mechanism of this disease.