Pastosity is a moderate swelling of the skin and subcutaneous tissue. The term comes from the Latin word pasta - "dough". It is characterized by pallor of the skin, a decrease in elasticity and resembles the structure of a test on palpation. It is the precursor of edema.
The symptom is often of aesthetic concern. May be a transient problem and progress to fixed tissue swelling.
Local links in the development of pastosity
Pathogenesis has the same links as with edema. The difference lies in the degree of change that has taken place.
So this is happening:
- Increase in hydrostatic pressure in the capillaries, which leads to increased filtration of water from the cell into the intercellular space.
- Decrease in hydrostatic pressure in tissues. Strengthening the release of fluid from the blood into the tissues.
- Violation of osmotic balance with an increase in s alts ininterstitial fluid, which attract water molecules from cells.
- Increased water in the intercellular space due to a lack of proteins in the blood plasma that hold water molecules in the bloodstream.
- Increase in the permeability of the vascular wall, when the fluid can safely leave the cells and enter the surrounding tissue.
- Violation of lymph outflow.
Causes of Pastosity
There are two groups of causative factors.
Pathological conditions accompanied by sodium retention in the body:
- cirrhosis of the liver (severe course with symptoms of portal hypertension);
- kidney disease (impaired excretory function);
- an excess of mineralocorticoids in the body, which contributes to the retention of sodium and water ions in the body;
- medication (NSAIDs, corticosteroids).
Reduced protein (albumin fraction):
- liver disease (impaired protein synthesis);
- nephrotic syndrome (protein is lost in urine).
Clinical classification of pastosity
Based on two principles: causal and organ.
Classification:
- Heart. The contractile activity of the myocardium decreases and venous congestion occurs. Gradually, the veins expand compensatory, and part of the blood enters the intercellular space.
- Renal. A dual situation occurs: loss of protein and a decrease in oncotic pressure. Fluid leaks into surrounding tissues, volume decreasescirculating fluid and the renin-angiotensin-aldosterone system is activated. All this leads to sodium and water retention, exacerbating the edematous syndrome.
- Inflammatory. One of the components of the inflammatory response is tissue swelling due to local vasodilation and sweating of the liquid part of the blood with the formation of exudate.
- Allergic. In response to contact with the allergen, mediators are released, which dilate the vessels and increase their permeability. Fluid is released into the surrounding tissues.
- Cachectic. Associated with a lack of protein in the diet. The albumin fraction retains water molecules in the bloodstream, and when they are deficient, the fluid enters the intercellular space. There is such an expression "to swell from hunger", which is appropriate in this case.
- Endocrine. With a decrease in thyroid hormones, all types of metabolism slow down. In the skin, there is an accumulation of excess glycosaminoglycans, sodium and fluid retention. There is a specific swelling of the face (myxedema).
Passion symptoms
Puffiness is a symptom that can occur at any time of the day.
Puffiness of the face in the morning. It is associated with a long horizontal position and looseness of the subcutaneous tissue of the face. It is localized more often in the periorbital region. Gradually passes, this is due to the transition to a vertical position and a gradual outflow of fluid. Pathological swelling of the face is observed in diseases of the kidneys.
Puffiness in the evening. It is observed in heart failure in the form of gravitational pastosity of the lower extremities. The shin area loses its relief and, when pressed on the skin, pits from the fingers remain.
What is body pastiness? It can be observed with excessive use of s alt and water, during pregnancy, during the premenstrual period, with insomnia, general overwork. Fluid is evenly distributed and swelling subsides when causative factors are removed.
Diagnosis of pastosity
There is a McClure-Aldrich test for increased tissue hydrophilicity. 0.2 ml of isotonic sodium chloride solution is injected intradermally. Normally, the formed blister resolves within an hour. The more pronounced the hydrophilicity of the tissues, the faster the edema resolves.
To identify pathological conditions in the body, it is necessary to undergo a minimum clinical examination: blood and urine tests, ECG.
When these indicators change, the diagnostic search expands.
Treatment of pastosity
Treatment of the underlying disease that caused it should be carried out taking into account the following recommendations:
- Diet. It is necessary to limit the water load on the body. Monitor diuresis so that the amount of fluid drunk is equal to the amount of urine excreted. It is not recommended to drink liquid 3 hours before bedtime. Limit s alt intake to 3 g/day.
- The correct mode of work and rest. Need to sleep. The pillow should becomfortable.
- Massage that helps to increase the outflow of lymph.
- After a hard day's work, it is necessary to unload the lower limbs, giving them an elevated position. This improves venous outflow of blood.
Pastosity in medicine is about the pathology of vital organs. Needs early detection and treatment Is a precursor to edema.
