MILROY'S SYNDROME
MILROY'S DISEASE
Congenital Lymphedema
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Milroy's Syndrome
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Related Terms: Nonne-Milroy lymphedema, Milroy's Disease, Primary congenital hereditary lymphedema, hereditary lymphedema I, Nonne-Milroy-Meige disease, hereditary tropholymphoedema syndrome; idiopathic hereditary lymphedema, lymphoedema; lymphedema, early onset type; trophoedema hereditarium (chronicum extremitatum inferiorum); tropholymphoedema, elephantiasis congenita hereditaria, familial hereditary oedemaSee also: Lymphedema
http://www.lymphedemapeople.com/thesite/all_about_lymphedema.htm
Disorder Subdivisions - Lymphedema
Hereditary
Lymphedema, Type I
Congenital
Hereditary
Lymphedema
Milroy
Disease
Nonne-Milroy-Meige
Syndrome
Hereditary
Lymphedema, Type
II
Meige's
Lymphedema
Familial
Lymphedema Praecox
Hereditary
Lymphedema Tarda
Milroy's Syndrome
Milroy's Syndrome is an old term used to describe hereditary congenital
lymphedema. It is a congenital familial primary lymphedema which
results from vertical
autosomal inheritance of a single gene. The gene has been identified
as VEGFR3. The condition usually presents itself at birth with the
swelling of
one or even both legs.
If the condition is unilateral (single leg), the other leg may continue
in the
latency stage for years before expressing itself. The same is indicated
for arm
lymphedema.
It is the rarest of the inherited lymphedema, accounting for
approximately 2% of
hereditary lymphedemas.
Hereditary lymphedema was first described by Nonne in 1891, however in
1892 Dr.
William F. Milroy described a missionary who had returned from work in
India who
had swollen legs his entire life. His mother likewise was afflicted
with
the same condition. Milroy had also, previously studied the 250 year
history of
a family and had been able to identify 22 persons with this condition
through 6
generations. He was also able to pinpoint when the condition entered
the family
through a marriage in 1768.
Diagnosis
Basic diagnosis can be made by the fact that swelling (generally of the legs) presents at birth and there is a family history of similar swelling. Currently the most precise diagnosis can be made by a lymphoscintigraphy test. In this test a radioactive substance is injected into the limb and is traced on a computer screen. Through this method the exact location of the lymphatic blockages can be identified.
Etiology
The cause of Milroy's Syndrome is a break in the VEGFR3 gene.
Complications
The usual complications involved with the condition include fibrosis of the limb tissues, cellulitis (and or lymphangitis and erysipelas infections). Other complications made include involvement of the genitalia, pain, skin conditions and in very rare situations lymphangiosarcoma, inflammation and various defects, including distichiasis, extradural cysts, vertebral anomalies, cerebrovascular malformations, yellow nails.
Treatment
Decongestive therapy is the most widely accepted form of treatment. There is no cure for Milroy's but the condition can be managed by early diagnosis and treatment. Other treatments involved will focus on the complications such as infections, pain and associated skin problems.
Other therapies used may include compression pump therapy and surgical procedures.
Prognosis
Long term prognosis is excellent is the condition is identified early and treatment begins so after the diagnosis is made.
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Stages of Milroy's Syndrome (Lymphedema)
LATENCY STAGE
Lymphatic transport capacity is reduced
No visible/palpable edema
Subjective complaints are possible
STAGE I
(Reversible Lymphedema)
Accumulation of protein rich edema fluid
Pitting edema
Reduces with elevation (no fibrosis)
STAGE II
(Spontaneously Irreversible Lymphedema)
Accumulation of protein rich edema fluid
Pitting becomes progressively more difficult
Connective tissue proliferation (fibrosis)
STAGE III
(Lymphostatic Elephantiasis)
Accumulation of protein rich edema fluid
Non pitting
Fibrosis and sclerosis (severe induration)
Skin changes (papillomas, hyperkeratosis, etc.)
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Fibrosis in Milroy's Syndrome
Long standing lymphedema causes a condition known as fibrosis.
As the fluid
continually collects in a limb, it becomes hard and dense. With each
stage of
lymphedema there is also a change in the tissue texture of a limb.
With stage one the tissue is still much like normal tissue, its just
satiated
with fluid. As the swelling continues and as he fluid changes to that
protein-rich fluid referred to a lymphorrea, you enter into stage two.
In this
stage, the tissue become very similar to a grape (best image I can
think of).
Already it is becoming much more difficult for antibiotics to reach
bacteria and
it becomes less response to the decongestive therapy.
At stage three, the tissue become similar to one of those old synthetic
kitchen
sponges, the ones that become rock hard when they are dry.
This is the very real serious side affect of stage three lymphedema.
This type
of tissue increases potential of persistent and very hard to treat
cellulitis or
lymphangitis.
The denseness of the limb prohibits antibiotics from reaching the
infecting
bacterium and it is often able to survive in pockets of fibrotic
tissue. These
pockets act as a septic foci and after antibiotic treatment is
completed, the
infections will reappear.
Generally at this stage it is going to take IV antibiotics to deal with
any
infection because oral antibiotics just are not able to penetrate this
mass of
hard tissue.
Also, as the fibrosis intensifies you become more susceptible to deep
venous
thrombosis (DVT) and other circulatory problems. You may also start to
experience neuropathy as the pressure of this tissue compresses nerves
within
the limb.
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Decongestive Therapy and Milroy's Syndrome
Manual
Lymphatic Drainage (MLD): is a unique, therapeutic method of
stimulating the
movement of fluids in the tissues. The gentle, rhythmic, pumping,
massage
movements follow the direction of lymph flow and produce rapid results.
It
assists the cutaneous lymphatics in picking up and removing not just
fluids, but
all the waste products, protein particles and debris from our system.
It also is
successful in breaking fibrosis and fibrotic areas of a lymphodemous
limb.
This treatment was created and developed Danish therapists Dr. Emil
Vodder and
his wife, Estrid, in the 1930's and was introduced in Paris in 1936.
They are
also credit with creating a specialty of medicine called Lymphology.
First brought to North America in 1982, the school is located in
Victoria, British Columbia, Canada. Before it was introduced the
standard
treatment course in North American was either a surgery called
debulking or the
use of compression machines wherein the limb was literally squeezed by
pneumatic
air pressure.
Comprehensive Decongestive Therapy (CDT) is used primarily in the
treatment of
lymphedema and venous insufficiency edema. It is a combination of MLD,
bandaging
exercises and skin care. CDT may also involve breathing exercises,
compressive
garments and dietary measures. A frequent indication for CDT is
lymphedema
caused by irradiation or surgery due to cancer. It can relieve edema,
fibrosis
and the accompanying pain and discomfort.
Also known as Complete Decongestive Physiotherapy (CDP), this treatment
therapy
was pioneered in the United States by Dr. Robert Lerner.
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Cellulitis and Milroy's Syndrome
Acute
Cellulitis is one of the complications of
lymphedema. The patient may not be aware of the source of the etiology.
Sometimes it may be a cut, mosquito bite, open wound or other infection
in the
body.
The first sign is increased or different quality of PAIN involving the
lymphedema limb. The patients often describe this as a "flu like
symptom or
an ache" involving the Lymphedema arm or leg. This is usually followed
by
sudden onset of ERYTHEMA(redness, red streaks or blotches) on the
involved limb.
The HYPERTHERMIA(lymphedema limb becomes warm, hot) will follow and the
patient
may experience the CHILLS and even HIGH FEVER.
The early intervention and treatment with antibiotics will resolve this
condition (it usually takes a very minimum ten day course of
antibiotics). Only
a Medical Doctor will be able to prescribe the Antibiotics, thus a
consultation
with a Doctor is necessary. Severe Cellulitis may require Inter venous
Antibiotic treatment and hospitalization. Again, elevation of the
affected limb
is important.
During that phase the patient should NOT massage the Lymphedema limb,
bandage,
apply the pump, wear tight elastic sleeve or exercise excessively.
Avoid the
blood pressure and blood to be drawn from the involved arm. Keep the
limb
elevated as much as possible while resting. Once the symptoms dissipate
the
treatment MLD/CDP should be initiated.
How do we prevent this infection? The patient should be careful with
daily
activities and take all precautions to protect the skin (wear gloves
when
gardening, cleaning with detergents, etc.. ).
If
an injury to skin occurs on the
Lymphedema limb it is necessary to clean the wound with alcohol or
hydrogen
peroxide and apply Neosporin/Polysporin antibiotic ointment. If the
symptoms
progress seek the attention of a physician immediately.
It is so very important to avoid getting cellulitus as it further
destroys the
lymphatic system. Allowed to spread or continue it can become systemic
and can
lead to gangrene, amputation of the limb or even death.
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Noone-Milroy-Type Hereditary Lymphedema
Also known as Lymphedema I, this disorder presents as brawny edema
usually of
the lower extremity. The diagnosis is usually made at birth. Tissue
swelling
occurs distally or proximally in the involved limbs, and either
hypoplasia or
hyperplasia of the lymphatics has been found.
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Prenatal diagnosis of
Milroy's primary congenital
lymphedema.
Makhoul IR, Sujov P, Ghanem N, Bronshtein M.
Department of Neonatology, Rambam Medical Center, Bat-Galim, Haifa,
Israel.
Makhoul@rambam.health.gov.il
Milroy's primary congenital lymphedema (PCL) (hereditary lymphedema
type I,
Milroy disease) is present at birth, and mostly affects the dorsal
aspects of
feet. It is mostly a life-long condition but does not affect longevity.
Complications are rare except for chronic discomfort and warmness of
affected
areas. PCL is an autosomal dominant disease with incomplete penetrance
due to a
mutation in the gene locus encoding for VEGFR3 with resultant
dysgenesis of
microlymphatic vessels. We report on two fetuses where ultrasonographic
examination at 15 weeks of gestation showed significant edema of the
dorsal
aspects of both feet with no evidence of other major malformations.
Whereas in
one fetus the edema resolved completely, it persisted in the second
fetus and
proved after birth to be of lymphedematous nature. To the best of our
knowledge,
this is the first report of early prenatal diagnosis of primary
congenital
lymphedema via fetal ultrasonographic examination and of spontaneous
resolution
of lymphedema during fetal life. Copyright 2002 John Wiley &
Sons, Ltd.
Pub Med
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Primary
Lymphedema - Milroy's Disease
Excerpt from Milroy Disease
http://www.emedicine.com/med/byname/milroy-disease.htm
Milroy's Syndrome - Genetic Cause
Congenital hereditary
lymphedema caused by a mutation that
inactivates VEGFR3 tyrosine kinase.
Irrthum A, Karkkainen MJ, Devriendt K, Alitalo K, Vikkula M.
Laboratory of Human Molecular Genetics, Christian de Duve Institute of
Cellular
Pathology and Universite catholique de Louvain, B-1200 Brussels,
Belgium.
Hereditary lymphedema is a chronic swelling of limbs due to dysfunction
of
lymphatic vessels. An autosomal dominant, congenital form of the
disease, also
known as "Milroy disease," has been mapped to the telomeric part of
chromosome 5q, in the region 5q34-q35. This region contains a good
candidate
gene for the disease, VEGFR3 (FLT4), that encodes a receptor tyrosine
kinase
specific for lymphatic vessels. To clarify the role of VEGFR3 in the
etiology of
the disease, we have analyzed a family with hereditary lymphedema. We
show
linkage of the disease with markers in 5q34-q35, including a VEGFR3
intragenic
polymorphism, and we describe an A-->G transition that
cosegregates with the
disease, corresponding to a histidine-to-arginine substitution in the
catalytic
loop of the protein. In addition, we show, by in vitro expression, that
this
mutation inhibits the autophosphorylation of the receptor. Thus,
defective
VEGFR3 signaling seems to be the cause of congenital hereditary
lymphedema
linked to 5q34-q35.
Pub Med
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Recurrent septic
arthritis and Milroy's disease.
Albornoz MA, Myers AR.
Division of Rheumatology and Immunologic Diseases, Temple University
Health
Sciences Center, Philadelphia, PA 19140.
Milroy's disease is a rare disorder characterized by multiple physical
anomalies, the most prominent of which is lymphedema of one or both
lower
extremities. We describe, with a review of proposed pathogenetic
mechanisms, a
patient with Milroy's disease who, over a 13-year period, manifested at
least 14
isolated episodes of septic arthritis of the left knee. Recurrent
septic
arthritis associated with Milroy's disease has not been reported
previously.
Medline Plus
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LYMPHANGIOSARCOMA ON CONGENITAL LYMPHOEDEMA - Milroy's Syndrome
Key Words: Chronic Lymphoedema Lymphangiosarcoma, Milroy disease
Case
report:
A
31 years old white male complaining of congenital – familial form-
non previously treated lymphoedema
-
Milroy disease - was admitted with the aspect seen - Images
1,2,3 -. A biopsy
revealed
the presence of lymphangiosarcoma – Images 4,5,6 -.
No evidence of
metastatic disease was clinically evident. High AK amputation was
indicated and
performed followed by prosthetic extremity replacement. No
complementary
treatment was done. Patient is free of the disease three years after
operation
and no evidence recurrence has been noticed so far..
Lymphoedema
(1) may be primary or secondary to the presence of other disease and/or
to the
consequences of surgery or trauma (2). Primary lymphoedema may be
congenital –
Milroy´s disease – or may occur at any phase of life but it most
commonly
appears at puberty – Meig’s disease -. Secondary lymphoedema is
encountered
more often. The most prevalent worldwide cause of lymphoedema is
filariasis,
which is particularly common in south-east Asia and Africa. In Western
countries
postsurgical lymphoedema of the extremity prevails. Complications of
chronic
limb lymphoedema include recurrent cellulitis and lymphangiosarcoma
albeit other
tumors such squamous-cell carcinoma (3,4), b-cell lymphoma (5)
and angiosarcoma (6,7,8,9)
has been reported.
In
cases of long-lasting or congenital lymphoedema the finding of
ulceration,
violaceous nodules or papules, or apparent traumatic ecchymoses should
act as a
diagnostic beacon warning of dangers. A case is reported of a
high-grade
lymphangiosarcoma developing in a patient with congenital hereditary
lymphoedema
(Milroy's disease) in a familial form (10). Hereditary lymphoedemas
that are not
associated with other malformations usually affect the lower limbs and
are
inherited in an autosomal dominant fashion. These non-syndromic
hereditary
lymphoedemas are categorized by their age of onset, being either
congenital
(Milroy disease) or having an onset in childhood or around puberty
(Meige
disease) (11). Development of lymphangiosarcoma
is usually
associated with
post-mastectomy lymphoedema, has been
described in late-onset hereditary lymphoedema. There is a high
incidence of
multiple primary tumors in association with lymphangiosarcoma in the
literature
(12).
Lymphangiosarcoma is a rare, aggressive, vascular neoplasm arising in chronic congenital or acquired lymphedema. Although it is most frequently associated with post-mastectomy lymphedema (Stewart-Treves's syndrome), lymphangiosarcoma can exceptionally arise in congenital hereditary lymphedema (11)(Milroy's syndrome and Meige's syndrome) and non-hereditary lymphoedema (congenital, praecox or forme tarde lymphoedemas) (13).
The
risk of appearance of lymphangiosarcoma following mastectomy and
radiation
therapy has been recently analyzed. Between 1954 and 1983, 7620
patients were
treated for breast carcinoma at Institut Gustave Roussy (France) (14).
Of these
patients, 6919 were followed for at least 1 year. Out of these, 11
presented
with sarcomas thought to be induced by irradiation, 2 of which were
Steward-Treves
Syndrome, and 9 of which were sarcomas within the irradiated fields.
All
histological slides were reviewed and a comparison with those of breast
cancer
was done. The sites of these sarcomas were: parietal wall, 1 case;
second costal
cartilage, 1 case; infraclavicular region, 1 case; supraclavicular
region, 2
cases; internal third of the clavicle, 2 cases; axillary region 2
cases; and the
internal side of the upper arm (Stewart-Treves syndrome), 2 cases. The
median
age of these 11 patients at the diagnosis of sarcomas was 65.8 (49-83).
The mean
latent period was 9.5 years (4-24). Three patients underwent radical
mastectomy
and nine modified radical mastectomy. Only one patient received
chemotherapy.
The radiation doses received at the site of the sarcoma were 45 Gy/18
fr. for 10
cases and 90-100 Gy for 1 case (due to overlapping between two fields).
The
histology was as follows: malignant fibrous histiocytoma, 5 cases;
fibrosarcoma,
3 cases; lymphangiosarcoma, 2 cases; and osteochondrosarcoma, 1 case.
The median
survival following diagnosis of sarcoma was 2.4 years (4 months-9
years). Two
patients are still alive: one with recurrence of her breast cancer, the
other in
complete remission, with 7 and 3 years follow-up, respectively. All
other
patients died from their sarcomas. The cumulative incidence of sarcoma
following
irradiation of breast cancer was 0.2% (0.09-0.47) at 10 years. The
standardized
incidence ratio (SIR) of sarcoma (observed n# of cases (Obs)/expected
n# of
cases (Exp) computed from the Danish Cancer Registry for the same
period) was
1.81 (CI 0.91-3.23). This is significantly higher than one, with a p =
0.03 (One
Tailed Exact Test). The mean annual excess (Obs-Exp)/100.000
person-years at
risk during the same period/(100,000) was 9.92. This study suggests
that
patients treated by radiation for breast cancer have a risk of
subsequent
sarcomas that is higher than the general population. However, the
benefit from
adjuvant radiation therapy in the treatment of breast cancer exceeds
the risk of
second cancer; therefore, the potential of radiation-induced sarcomas
should not
be a factor in the selection of treatment for patients with breast
cancer
Moreover, we emphasized the importance of regular clinical controls in all patients affected by chronic lymphoedema (15,16). In fact, although the prognosis of this neoplasm is very poor, a prompt diagnosis and a rapid, ablative surgery associated with radiation therapy can increase the possibility of survival of these patients (17,18). Chemotherapy with intraarterial mitoxantrone and placitaxel with ex vivo previous sensitivity test seems a current adequate complementary approach (19).
http://www.sc.ehu.es/scrwwwsr/kirurgia/Kirurgia2003b/Linfangiosarcoma.htm
..................................
Primary congenital lymphedema (Milroy's)
Véronique Mirlesse MD*, Ronaldo Levy MD*, Geneviève Brodaty MD*, Pascale Sonigo MD**, Dominique Teillac MD***, Luc Gourand, MD*, Fernand Daffos MD* Fernando Heredia MD"
*
Service de médecine foetale, Institut de Puériculture et Périnatalogie,
Paris.
** Service de radio-pédiatrie, Hopital Necker Enfants Malades, Paris
*** Service de dermatologie, Hopital Necker Enfants Malades, Paris
" Women"s Health Alliance, Nashville, Tennessee.
Synonyms: Hereditary lymphedema type I, Nonne-Milroy Lymphedema, early-onset lymphedema, primary congenital lymphedema.
Incidence: 1:33,000 newborn. Male to female ratio 1:2,3[1],[2]
Etiology: Autosomal dominant with incomplete penetrance. The gene mutation has been found near the most telomeric region of 5q35.32,[8] There is also some evidence of 2 different sub-mutations or variants depending on the nucleotide substituted[9],[10],[11],[12],[13].
Pathogenesis:All the anomalies found are due to dysgenesis of lymphatic microvessels. These dysgenesis ranges from mild to severe and even to aplasia of both, the lymphatic capillaries and collectors[14],[15],[16].
Main features: Present in one or both legs at birth. Lymphedema of PCL persists throughout life but does not appear to affect longevity. As the patient matures, the overlying skin displays a slightly rosy hue, and the size of the edematous parts remains proportional to the remainder of the body. It can rarely present with genital edema, resembling sexual ambiguity[3].
Ultrasound appearance:This condition is suggested by the finding of an isolated edema of the dorsum of feet in the fetus, a normal karyotype and absence of other significant malformations.
Case report:
These are images obtained during a 28-week routine ultrasound examination. Fetal weight was over the 97th centile.
Fetal lower
limbs: Edema of the lower limbs,
specially the distal portions. Compare the width of legs and thighs.
Differential diagnosis:
Possible complications:
Reported complications, although rare, have been reported:
Management: If other fetal anomalies are ruled out, and fetal karyotype is normal, parental counseling concerning etiology, management, and possible complications is advisable.
[1] Makhoul IR, Sujov P, Ghanem N, Bronshtein M. Prenatal diagnosis of Milroy"s primary congenital lymphedema. Prenat Diagn 2002 Sep;22(9):823-6
[2] Ferrell RE, Levinson KL, Esman JH, Kimak MA, Lawrence EC, Barmada MM, Finegold DN. Hereditary lymphedema: evidence for linkage and genetic heterogeneity. Hum Mol Genet 1998 Dec;7(13):2073-8
[3] Sarda P, Jalaguier J, Montoya F, Bonnet H. Hereditary congenital lymphedema with pseudosexual ambiguity.J Genet Hum 1988 Aug;36(4):353-60
[4] Dale RF.Primary lymphoedema when found with distichiasis is of the type defined as bilateral hyperplasia by lymphography. J Med Genet 1987 Mar;24(3):170-1
[5] Fang J, Dagenais SL, Erickson RP, Arlt MF, Glynn MW, Gorski JL, Seaver LH, Glover TW. Mutations in FOXC2 (MFH-1), a forkhead family transcription factor, are responsible for the hereditary lymphedema-distichiasis syndrome.Am J Hum Genet 2000 Dec;67(6):1382-8
[6] Herbert FA, Bowen PA. Hereditary late-onset lymphedema with pleural effusion and laryngeal edema. Arch Intern Med 1983 May;143(5):913-5
[7] Mucke J, Hoepffner W, Scheerschmidt G, Gornig H, Beyreiss K. Early onset lymphoedema, recessive form--a new form of genetic lymphoedema syndrome. Eur J Pediatr 1986 Aug;145(3):195-8
[8] Evans AL, Brice G, Sotirova V, Mortimer P, Beninson J, Burnand K, Rosbotham J, Child A, Sarfarazi M. Mapping of primary congenital lymphedema to the 5q35.3 region. Am J Hum Genet 1999 Feb;64(2):547-55
[9] Irrthum A, Karkkainen MJ, Devriendt K, Alitalo K, Vikkula M. Congenital hereditary lymphedema caused by a mutation that inactivates VEGFR3 tyrosine kinase. Am J Hum Genet 2000 Aug;67(2):295-301
[10] Karkkainen MJ, Ferrell RE, Lawrence EC, Kimak MA, Levinson KL, McTigue MA,Alitalo K, Finegold DN. Missense mutations interfere with VEGFR-3 signalling in primary lymphoedema.Nat Genet 2000 Jun;25(2):153-9
[11] Finegold DN, Kimak MA, Lawrence EC, Levinson KL, Cherniske EM, Pober BR, Dunlap JW, Ferrell RE. Truncating mutations in FOXC2 cause multiple lymphedema syndromes. Hum Mol Genet 2001 May 15;10(11):1185-9
[12] Holberg CJ, Erickson RP, Bernas MJ, Witte MH, Fultz KE, Andrade M, Witte CL. Segregation analyses and a genome-wide linkage search confirm genetic heterogeneity and suggest oligogenic inheritance in some Milroy congenitalprimary lymphedema families. Am J Med Genet 2001 Feb 1;98(4):303-12
[13] Jeltsch M, Kaipainen A, Joukov V, Meng X, Lakso M, Rauvala H, Swartz M, Fukumura D, Jain RK, Alitalo K. Hyperplasia of lymphatic vessels in VEGF-C transgenic mice. Science 1997 May 30;276(5317):1423-5
[14] Partsch H, Urbanek A, Wenzel-Hora B. The dermal lymphatics in lymphoedema visualized by indirect lymphography. Br J Dermatol 1984 Apr;110(4):431-8
[15] Bollinger A, Isenring G, Franzeck UK, Brunner U. Aplasia of superficial lymphatic capillaries in hereditary and connatal lymphedema (Milroy"s disease). Lymphology 1983 Mar;16(1):27-30
[16] Pfister G, Saesseli B, Hoffmann U, Geiger M, Bollinger A. Diameters of lymphatic capillaries in patients with different forms of primary lymphedema. Lymphology 1990 Sep;23(3):140-4
[17] Wheeler ES, Chan V, Wassman R, Rimoin DL, Lesavoy MA. Familial lymphedema praecox: Meige"s disease. Plast Reconstr Surg 1981 Mar;67(3):362-4
[18] Mehta SD, Robinson RJ, Bern SA. Pedal manifestations of Milroy"s disease. J Am Podiatr Med Assoc 1996 Aug;86(8):400-2
[19] Albornoz MA, Myers AR. Recurrent septic arthritis and Milroy"s disease. J Rheumatol 1988 Nov;15(11):1726-8
[20] Offori TW, Platt CC, Stephens M, Hopkinson GB. Angiosarcoma in congenital hereditary lymphoedema (Milroy"s disease)--diagnostic beacons and a review of the literature. Clin Exp Dermatol 1993 Mar;18(2):174-7
[21] Brostrom LA, Nilsonne U, Kronberg M, Soderberg G. Lymphangiosarcoma in chronic hereditary oedema (Milroy"s disease). Ann Chir Gynaecol 1989;78(4):320-3
http://www.thefetus.net/page.php?id=1035
======================
Milroy's Disease Treatment and Management
Medscape Reference
http://emedicine.medscape.com/article/299840-treatment
===========
Milroy's Disease - a parents view
http://tjmum.hubpages.com/hub/Milroys-Disease
===========
What is Milroy's Disease?
http://www.netdoctor.co.uk/ate/heartandblood/202958.html
===========
http://onlinelibrary.wiley.com/doi/10.1111/j.1525-1470.2010.01202.x/abstract
=======================================
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Reflexology Therapy
http://www.lymphedemapeople.com/thesite/lymphedema_and_reflexology_therapy.htm
Lymphedema Surgeries
http://www.lymphedemapeople.com/thesite/lymphedema_surgeries.htm
Lymphedema Treatments are Poorly Utilized
ttp:ttp://www.lymphedemapeople.com/thesite/lymphedema_treatments_are_poorly_utilized.htm
Lymphedema Treatment Programs Canada
http://www.lymphedemapeople.com/thesite/lymphedema_treatment_programs_canada.htm
Wholistic Treatment
http://www.lymphedemapeople.com/thesite/lymphedema_wholistic_treatment.htm
Microsurgeries
http://www.lymphedemapeople.com/thesite/lymphedema_and_microsurgery.htm
Homeopathy
http://www.lymphedemapeople.com/thesite/lymphedema_and_homeopathy.htm
Aromatherapy
http://www.lymphedemapeople.com/thesite/lymphedema_and_aromatherapy
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Lymphedema People
Support Groups
-----------------------------------------------
Children
with Lymphedema
The time has come for families, parents, caregivers to have a support
group of
their own. Support group for parents, families and caregivers of
chilren with
lymphedema. Sharing information on coping, diagnosis, treatment and
prognosis.
Sponsored by Lymphedema People.
http://health.groups.yahoo.com/group/childrenwithlymphedema/
Subscribe: childrenwithlymphedema-subscribe@yahoogroups.com
......................
Lipedema
Lipodema Lipoedema
No matter how you spell it, this is another very little understood and
totally
frustrating conditions out there. This will be a support group for
those
suffering with lipedema/lipodema. A place for information, sharing
experiences,
exploring treatment options and coping.
Come join, be a part of the family!
http://health.groups.yahoo.com/group/lipedema_lipodema_lipoedema/?yguid=209645515
Subscribe: lipedema_lipodema_lipoedema-subscribe@yahoogroups.com
......................
MEN WITH LYMPHEDEMA
If you are a man with
lymphedema; a man with a loved
one with lymphedema who you are trying to help and understand come join
us and
discover what it is to be the master instead of the sufferer of
lymphedema.
http://health.groups.yahoo.com/group/menwithlymphedema/
Subscribe: menwithlymphedema-subscribe@yahoogroups.com
......................
All
About Lymphangiectasia
Support group for parents, patients, children who suffer from all forms
of
lymphangiectasia. This condition is caused by dilation of the
lymphatics. It can
affect the intestinal tract, lungs and other critical body areas.
http://health.groups.yahoo.com/group/allaboutlymphangiectasia/
Subscribe: allaboutlymphangiectasia-subscribe@yahoogroups.com
......................
Lymphatic
Disorders Support Group @ Yahoo Groups
While we have a number of support groups for lymphedema... there is
nothing out
there for other lymphatic disorders. Because we have one of the most
comprehensive information sites on all lymphatic disorders, I thought
perhaps,
it is time that one be offered.
DISCRIPTION
Information and support for rare and unusual disorders affecting the
lymph
system. Includes lymphangiomas, lymphatic malformations,
telangiectasia,
hennekam's syndrome, distichiasis, Figueroa
syndrome, ptosis syndrome, plus many more. Extensive database of
information
available through sister site Lymphedema People.
http://health.groups.yahoo.com/group/lymphaticdisorders/
Subscribe: lymphaticdisorders-subscribe@yahoogroups.com
At our home page we have 18 categories with 218 articles
on lymphedema, edema, and related conditions:
The Forums
Lymphedema Information
Lymphedema and Edema Related Conditions
Hereditary Conditions of the Lymphatics
Related Medical Conditions
Complications of Lymphedema
Lymphedema Treatment Options
Complete Listings of Therapists and Links
Cellulitis and Related Infections
Wound Information, Care, Treatment
Skin Care, Conditions and Complications
Exercise, Diets, Nutrition
Miscellaneous Interesting Articles section
Resources, Organizations, Support Groups
Government Resources
Advocacy and Lobbying Resources
Resources for the Medical Community
===================================================
Our Home Page: Lymphedema People
http://www.lymphedemapeople.com/
Updated Dec. 26, 2011