Abstract

Idiopathic oedema or fluid retention syndrome occurs mainly in post pubertal women. Also known as cyclical oedema, it appears to be more commonly recognised than when we last discussed it,¹ and has recently been described in a few prepubertal children.² Patients with the syndrome retain abnormal amounts of salt and water while standing, in response to an excessive orthostatic fall in plasma volume.³ Their symptoms are frequently attributed to neuroticism, allergy or varicose veins, and incorrectly managed with excessive doses of diuretics.⁴ When should oedema be regarded as ‘idiopathic’, and how should it be managed?