Impact of basic lymphedema mgmt on dermatolymphangioadenitis

Wuchereria bancrofti vespid, Immune response, Serum immune complexes diagnosis, Diethylcarbamazine (DEC), Wolbachia in filarial parasites, Interdigital skin lesions, Urban Filariasis, Doxycycline, mass drug administration program, Filarial Lymphedema Care, Detection of filarial parasites, Albendazole, research abstracts

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Impact of basic lymphedema mgmt on dermatolymphangioadenitis

Postby patoco » Sat Sep 17, 2011 10:01 am

Impact of basic lymphedema management and antifilarial treatment on acute dermatolymphangioadenitis episodes and filarial antigenaemia

HA El-Nahas1, AM El-Shazly1, M Abulhassan2, NA Nabih1, N Mousa3
1 Department of Parasitology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
2 Department of Internal Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt
3 Department of Tropical Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt

Date of Web Publication 6-Aug-2011


Background: A major factor in the progression of lymphedema is acute dermatolymphangioadenitis (ADLA). Aims : To study ADLA episodes and antigenaemia in patients with different grades of filarial lymphedema at pre- and two years post-treatment. Setting and Design: A prospectively conducted study from May 2008 through May 2010.

Patients and Methods: Forty five patients complaining of limb swelling with present or past history of limb redness suggestive of ADLA attacks were included. Patients were clinically examined for lymphedema grading, detection of potential entry points and diagnosis of microfilaraemia. Wuchereria bancrofti antigen titer was estimated by "Trop-Ag W. Bancrofti" ELISA kit. Basic lymphedema management and treatment with antifilarial drugs were applied.

Statistical Analysis : Mann−Whitney test and Chi-square test were used. Results: The number of ADLA attacks in the pretreatment period, ranged from one to three per year. Mean duration of the attacks was 3.87±0.79 days. Entry points were detected in 82% of cases. The study revealed statistical significance between extension and grade of lymphedema and number of ADLA attacks per year (P=0.018 and 0.022, respectively). Microfilaraemia was detected in four cases and positive filarial antigenaemia were detected in 29 patients (64.4). The number of ADLA attacks per year significantly decreased from the pre-treatment period (mean: 2.05±0.560) to be 1.23±0.706 after one year and 0.89±0.575 after two years post treatment. There was a significant decrease in the mean antigen titer one year and two years after treatment.

Conclusion: Basic lymphedema management is effective for controlling ADLA attacks in areas where lymphatic filariasis is endemic.

Keywords: Acute dermatolymphangioadenitis, Filarial, Lymphedema

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