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How is my calf always edema recently?
Ms. Zhang, Pingjiang County, Yueyang City, Hunan Province: She is 45 years old. Since 1998, my calf is often swollen. It takes a long time to recover by pressing with your fingers, and sometimes your eyelids and face are swollen. For more than half a year, I feel that the situation is more serious than before. Excuse me, what disease may I have? What subjects should I read? What tests do you need to do for diagnosis?

A: Associate Professor Zhang from the Department of Nephrology, Xiangya Hospital believes that edema can be divided into cardiogenic, nephrogenic, hepatogenic and malnutrition, and it is suggested to consider it from five aspects. One is to rule out chronic nephritis, and the related tests can be routine urine test and 24-hour urine protein quantification. The second is to rule out the cause of heart, comprehensively consider whether it is difficult to climb stairs, and do ECG, heart B-ultrasound and other examinations. The third is to rule out liver problems. Poor liver function can also cause hypoproteinemia and edema. Blood can be drawn to check liver function. The fourth is to eliminate endocrine problems, such as hypothyroidism. In this respect, T3 and T4 can be checked by blood sampling, and the decrease of T4 and the normality of T3 can be used as one of the indicators for early diagnosis of hypothyroidism.

If these four conditions have been ruled out, it is clinically called female idiopathic edema. Women with this disease prefer women, and most of them are at childbearing age, aged between 20 and 50. Edema is often periodic. After the edema develops to a certain extent, the body can excrete more water and salt, and the edema can be alleviated after resting and lying down. Patients can do a standing position edema test at home: urinate after waking up in the morning, weigh and record, and weigh again 3 hours after meals for three consecutive days. If the weight difference between two times is greater than 1 kg, it can be used as a reference for diagnosis.

Of course, it should be noted that before the diagnosis of idiopathic edema is made, the possibility of other organic edema should be carefully ruled out to avoid misdiagnosis.

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