Systemic subclinical lymphedema due to obesity as the cause of clinical lymphedema: A new concept.

On evaluating patients with lymphedema, the authors found that obesity is associated with generalized edema of all extremities and the trunk with increased intracellular and extracellular fluids, thus suggesting a new concept of lymphedema that the authors have termed systemic subclinical lymphedema. Animal studies show that obesity and its progression lead to changes in the lymphatic system and microcirculation with alterations in lymphatic motility, inflammatory processes, capillary permeability and immune response. Systemic subclinical lymphedema is diagnosed when above normal fluid levels are detected in all the extremities and the trunk with the progression of obesity; this can lead to the appearance of clinical lymphedema of the extremities.