Symmetrical peripheral oedema in infants.

Case Reports Case 1. A male child was born in 1949 at term following a normal pregnancy and labour. His birth weight was 91 lb. Swelling of the feet was noted soon after birth. He was breast fed for two months and then reared on dried milk. On examination at the age of 6 weeks symmetrical pitting oedema of both feet extending a short distance up the legs was present. The hands were spared and no other abnormalities were found. B.P. was 80/50. INVESTIGATIONS. Urine was repeatedly negative for albumin and deposit. Hb was 70%, R.B.C. 3,500,000 per c.mm., W.B.C. 12,600 per c.mm. (neutrophils 44%, lymphocytes 49%, eosinophils 2%, monocytes 6%). Plasma proteins were 6 5 g. per 100 ml. (albumin 4-6 g. per 100 ml., globulin 19 g. per 100 ml.). Blood urea was 30 mg. per 100 ml. Biopsy from the dorsum of the foot showed that the epidermis was rather thin with oedema. The rete pegs were somewhat diminished and the corium a little thickened with some increase of collagen. There was slight perivascular infiltration with lymphoid cells. The oedema had vanished by the age of 18 months, while growth and development proceeded normally. When last seen at the age of 8 years the child was obese, weight 100 lb. (mean 591 lb.), height 55 in. (mean 50 in.), but was otherwise normal.