EpistemisGeneralized loss of tissue turgor
Specialty: General.
Why it occurs
- Subclinical chronic cellular dehydration due to hypodipsia or persistently insufficient water intake in frail adults
- Massive loss of collagen and elastin due to Cushing's syndrome (hypercortisolism that depresses the synthesis of fibroblasts and accelerates the proteolysis of connective tissue)
- Severe chronic protein-calorie malnutrition (which deprives the body of essential amino acids for the synthesis of extracellular matrix)
- Genetic collagen diseases of late onset or progressive manifestation (Ehlers-Danlos hypermobility or vascular type syndromes)
- Cachexia associated with premature senescence or advanced neoplasms that consume the extracellular matrix and supporting adipose tissue.
Initial workup
Complete serum electrolytes, calculated and measured serum and urinary osmolarity, urea nitrogen, creatinine, complete blood count (to evaluate hemoconcentration), morning serum cortisol levels, and assessment of global nutritional status.
red flags
Appearance of persistent skin fold lasting more than 3 seconds associated with mental confusion, severe orthostatic hypotension with recurrent syncope, extreme dryness of the tongue and oral mucosa with painful fissures, or extreme oliguria with high serum urea levels.
Standard management
- Scheduled oral fluid replacement with balanced oral rehydration solutions — 1 to 1.5 liters a day divided into small continuous doses
- Vitamin C supplementation — 500 mg per day) and hydrolyzed collagen (5 to 10 g per day orally to support tissue collagen synthesis
- Suspension or reduction of doses of loop diuretics or thiazides if they are not strictly essential.
Educational guidance for study. It is NOT a prescription recommendation. The actual choice depends on the cause, the patient, and current guidelines.
- Area
- General
- Listed causes
- 5
- Treatment options
- 3