Systemic causes

These include:

• congestive cardiac failure e.g. secondary to fluid overload, ischaemic heart disease
• hypoalbuminaemia e.g. liver disease, malnutrition, nephrotic syndrome
• iatrogenic lower limb swelling due to prescribed medication. There may be oedema following the use of medications such as non-steroidal anti-inflammatory drugs, calcium-channel blockers, thiazolidinediones, corticosteroids, gabapentin, pregabalin, levodopa and oral contraceptives containing oestrogen. (1)

Reference.

1. Koo LW, Reedy S, Smith JK. Patient history key to diagnosing peripheral oedema. Nurse Pract. 2010 Mar;35(3):44-52.