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 the test on palpation. It is the forerunner of edema.
Symptom often causes aesthetic concern. It can be a transient problem and go into fixed tissue edema.
Local links in the development of pastility
Pathogenesis has the same links as with edema. The difference lies in the degree of change that has taken shape.
So it happens:
- The 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 tissue.
- Violation of the osmotic balance with increasing salts in the interstitial fluid, which attract water molecules from the cells.
- The increase in water in the intercellular space due to a lack of proteins in the blood plasma that hold water molecules in the bloodstream.
- An increase in the permeability of the vascular wall, when the fluid can calmly leave cells and enter the surrounding fiber.
- Violation of the outflow of lymph.
Causes of Pastility
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 (excreted function is impaired);
- excess mineralocorticoids in the body, which contributes to the retention of sodium and water ions in the body;
- taking medications (non-steroidal anti-inflammatory, corticosteroids).
Decrease in protein ( albumin fraction ):
- liver disease (protein synthesis is impaired);
- nephrotic syndrome (protein is lost in the urine).
Clinical classification of pastiness
It is based on two principles: causal and organ.
Classification:
- Heartfelt. Myocardial contractility decreases and venous stasis occurs. Gradually, the veins expand compensatory, and there is a release of part of the blood into the intercellular space.
- Renal. There is a dual situation: loss of protein and a decrease in oncotic pressure. The fluid enters the surrounding tissues, the volume of circulating fluid decreases and the renin-angiotensin-aldosterone system is turned on. All this leads to a delay in sodium and water, exacerbating the edematous syndrome.
- Inflammatory One of the components of the inflammatory reaction 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 an allergen, a release of mediators occurs, which dilate blood vessels, increase their permeability. There is a release of fluid into the surrounding tissue.
- Cachectic. It is associated with protein deficiency in food. 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 "swell from hunger", which is appropriate in this case.
- Endocrine. With a decrease in thyroid hormones, all types of metabolism are slowed down. The skin accumulates an excess of glycosaminoglycans, a delay in sodium and fluid. A specific swelling of the face (myxedema) occurs.
Symptoms of Pastility
Pastosity is a symptom that can occur at any time of the day.
Pastasty face in the morning . It is associated with a long horizontal position and friability 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 with kidney diseases.
Pastosity in the evening . It is observed in heart failure in the form of gravitational pastiness of the lower extremities. The tibia region 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 salt and water, during pregnancy, in the premenstrual period, with insomnia, general overwork. The liquid is evenly distributed, and swelling goes away with the elimination of causal factors.
Diagnosis of pastility
There is a test of McClure-Aldrich for increased hydrophilicity of tissues. 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 swelling resolves.
To identify pathological conditions in the body, it is necessary to undergo a clinical minimum examination: blood and urine tests, ECG.
When these indicators change, the diagnostic search expands.
Pastosity Treatment
Treatment of the underlying disease that was the cause must 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 equals the amount of urine excreted. It is not recommended to drink liquid 3 hours before bedtime. Limit salt intake to 3 g / day.
- The correct mode of work and rest. Need to get enough sleep. The pillow should be comfortable.
- Massage, which enhances 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 the venous outflow of blood.
Pastosity in medicine is about the pathology of vital organs. Early detection and treatment needed. A precursor to edema.