title: Long term use of metformin in idiopathic cyclic edema, report of thirteen cases and review of the literature.
abstract: Idiopathic cyclic edema (ICE) is a rare cause of edema. To date, there is no standard of care. The physiopathology of ICE could be explained by an impairment of capillary permeability. In 1995, a study demonstrated the efficacy of metformin on symptoms and capillary permeability. We evaluated ICE-patients who were treated with metformin in our department.
  
  
  
  We retrospectively included patients diagnosed for ICE between January 1997 and October 2013. ICE was diagnosed in the presence of edema after excluding other etiologies. LANDIS test was used to support ICE diagnosis in all patients. The absence of edema at follow-up was considered as complete response (CR), partial decreased was considered as partial response (PR). Adverse events were recorded.
  
  
  
  Thirteen patients have accepted to use metformin. The median treatment duration was 28.5 months [8-167] and the median follow-up of treated patients was 40.5 months [14-167]. CR was reached in 10 patients (77%), and PR in 2 patients (15%). Two patients reported side-effects as diarrheas and one of them stopped the treatment due to mild diarrhea.
  
  
  
  We report the interest and tolerance of the long-term use of metformin in ICE. No severe adverse events were noticed. A prospective study is needed to confirm the efficacy of metformin in ICE-patients.
authors.affiliation: Department of Internal Medicine and National Center for Autoimmune Diseases, CHRU LILLE, UFR Medecine, F-59000 Lille, France, France.
authors.forename: S
authors.initials: S
authors.lastname: Soudet
authors.affiliation: Department of Internal Medicine and National Center for Autoimmune Diseases, CHRU LILLE, UFR Medecine, F-59000 Lille, France, France.
authors.forename: M
authors.initials: M
authors.lastname: Lambert
authors.affiliation: Department of Internal Medicine and National Center for Autoimmune Diseases, CHRU LILLE, UFR Medecine, F-59000 Lille, France, France.
authors.forename: G
authors.initials: G
authors.lastname: Lefèvre
authors.affiliation: Department of Internal Medicine and National Center for Autoimmune Diseases, CHRU LILLE, UFR Medecine, F-59000 Lille, France, France.
authors.forename: H
authors.initials: H
authors.lastname: Maillard
authors.affiliation: Department of Nuclear Medicine, Univ Lille Nord de France, F-59000 Lille, France.
authors.forename: D
authors.initials: D
authors.lastname: Huglo
authors.affiliation: Department of Internal Medicine and National Center for Autoimmune Diseases, CHRU LILLE, UFR Medecine, F-59000 Lille, France, France. Electronic address: pierre-yves.hatron@chru-lille.fr.
authors.forename: P Y
authors.initials: PY
authors.lastname: Hatron
mesh_terms: D000328:Adult; D000368:Aged; D002199:Capillary Permeability / Q000187:drug effects; D003967:Diarrhea / Q000139:chemically induced; D004487:Edema / Q000188:drug therapy* / Q000378:metabolism; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008687:Metformin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D007004:Hypoglycemic Agents; D008687:Metformin
keywords: Idiopathic cyclic edema; Metformin; Treatment