Elephantiasis, or elephantiasis of the legs, is a disease in which the limbs grow and become enormous in size due to the fact that the skin and subcutaneous tissue in them become very thick. What exactly causes this pathology, and how it can be treated, we will discuss in the article.
In the medical community, elephantiasis is also called lymphedema. It is based on a violation of the state of the lymphatic bed, which stops the outflow of lymph from the tissues and, accordingly, leads to their increase. The muscle tissue is saturated with proteins, which causes fibrotic changes in the subcutaneous tissue.
In medicine, a distinction is made between primary (congenital) and secondary (acquired) elephantiasis of the legs.
The occurrence of congenital lymphodema is provoked by genetic predisposition and problems in the formation of the child’s lymphatic system. By the way, most often this pathology occurs in women. And it can manifest itself both from childhood and in adulthood.
Depending on the species, elephantiasis has different causes. Thus, one of the prerequisites for the described pathology is considered to be infection of a person by Bancroft’s filaria larvae. These are parasitic worms that belong to the class of nematodes. They live in the lymphatic system of people, also affecting the subcutaneous tissue. And they are spread by mosquitoes that live in countries with subtropical and tropical climates. It is there that parasitic elephantiasis of the legs is especially common (a photo of this pathology can be seen in the article).
The filariae in the lymphatic ducts intertwine into balls, which, in fact, causes a slowdown in the outflow of lymph. In addition, they provoke compaction of the walls of blood vessels, which leads to their blockage as a result of thrombosis or stenosis. Thrombosed lymphatic vessels, by the way, often rupture.
The foci of necrosis present in such cases become a favorable environment for the development of coccal infection, which leads to the formation of abscesses.
In addition, as a result of the vital activity of parasites, especially in the case of their decay, substances appear that cause increased sensitivity of the skin in the form of rashes, inflammation, etc.
Doctors also include the appearance of malignant formations in the lymph nodes, their purulent inflammation (lymphadenitis), limb injuries, and erysipelas as the causes of the acquired disease - elephantiasis of the legs.
Sometimes the impetus for the development of the described disease is surgical intervention or some medical procedures, for example: radiotherapy, cosmetic venectomy, liposuction, arterial reconstruction, etc.
Elephantiasis of the feet is not a fatal disease, but it can lead to disability and greatly disrupt the patient’s normal course of life. In order not to miss the first symptoms of the disease, you need to know what they look like.
To the symptoms described above, you can add keratinization of the skin, the appearance of warts and chronic dermatitis. The legs feel heavy, fatigue increases, and pain occurs.
As you probably already guessed, you should contact specialists at the initial stage of the disease. That is, as soon as you notice that the swelling in your legs does not go away by the morning, and when pressed lightly it turns out to be soft and pliable, you should visit a doctor, otherwise the elephantiasis in your legs will steadily increase. Treatment at an early stage has the greatest chance of success.
The doctor will need to differentiate your disease from others with similar symptoms (varicose veins, deforming osteoarthritis, etc.). To do this, you will have to do lymphoscintigraphy, computed tomography, ultrasound and radiography.
Do not forget to mention in your conversation with your doctor your vacation in hot countries, if any, so that the specialist can exclude infection with filariae, which were mentioned above.
How to treat elephantiasis of the feet depends on the stage of elephantiasis. At the beginning of the disease, the doctor will recommend that the patient bandage the affected area with an elastic bandage to reduce swelling, wear compression stockings or stockings, and undergo massage and physical therapy sessions. There are also good reviews about regional barotherapy (this is a type of vacuum massage). A positive effect on the pathology of electrophoresis with trypsin and lidase and phonophoresis with apizartron was noted.
In addition to these procedures, the patient is also prescribed the drug Venoruton and Troxevasin ointment.
Treatment of elephantiasis in the stable, deforming or fibrous stage is usually carried out surgically. Thus, with the palliative method, the affected tissue is partially excised and drainage modifications are used to improve lymph outflow. This method is especially popular when treating elderly people and children.
In the advanced stage, a radical method is used: excision of the skin, connective tissue and fascia. However, such operations can have complications and require a long hospital stay.
Treatment of elephantiasis of the legs cannot be successful unless the patient reduces the load on the legs. While working, you should pause for 15 minutes, and it is better if during this time you have the opportunity to take a horizontal position and slightly raise your legs. At night it is also worth placing a soft cushion under them.
You should not sit cross-legged, wear tight shoes and clothes - all this slows down the flow of lymph. And the question of the possibility of visiting baths and saunas will be decided by the attending physician.
In addition, patients should remember that herbal medicine and folk remedies are not suitable for the treatment of elephantiasis. If you rely only on them, the optimal time to start treatment will pass, and you may not see results. There are no means for the so-called cleansing of the lymphatic system in modern medicine! Remember this and don't waste time!
Although elephantiasis in the unadvanced stage usually has a positive prognosis, measures that will help prevent its development will not be superfluous. This especially applies to those families where there have already been cases of this disease.
Doctors advise including chicory with ginger, tea brewed from lingonberry leaves with honey, and cranberry juice in the menu.
If even slight swelling appears on your legs, you should do a light foot massage and elevate your legs for 10-15 minutes.
A prerequisite is wearing comfortable shoes and an active lifestyle. Do not get carried away with salty and spicy foods and neglect the treatment of injuries, erysipelas and burns. Monitor your weight, and discuss the use of any medications to reduce swelling in your legs with your doctor, otherwise the consequences may be disastrous! Be healthy!
Experienced specialists know what elephantiasis is, treatment, causes and symptoms of this disease. This pathology is otherwise called elephantiasis or lymphedema. The disease develops due to stagnation of lymph. It manifests itself as pain in the lower extremities, an increase in their volume, and swelling. In the absence of therapeutic measures, this disease leads to the formation of trophic ulcers, fistulas and roughening of the skin.
Elephantiasis is a disease in which there is stagnation of lymph. The total number of such patients is about 10 million. The disease is widespread. Children often suffer.
Human lymphatic vessels are part of the lymphatic system. She takes part in the formation of immunity. Lymph itself is a clear liquid containing white blood cells, proteins, water, salts and other substances. It flows in the direction from bottom to top from the limbs into the duct.
There are 2 forms of elephantiasis: congenital and acquired. The congenital form is often detected in young children. It is caused by congenital disorders of the development of lymphatic vessels and valve apparatus. More than half of these patients are children under 18 years of age.
The following reasons for the development of primary (congenital) lymphedema are distinguished:
Nonne-Milroy-Mage syndrome is lymphedema combined with various developmental anomalies in children (endocrine disorders, hydrocele, kyphosis, infantilism). 24% of patients with Shereshevsky-Turner syndrome have lymph congestion. This is a genomic disease in which abnormalities of physical development and other disorders are observed.
The above diseases are characterized by disruption of the lymphatic system. In such children, small lymphatic vessels become thin and tortuous. Their expansion is observed. This causes disruption of the outflow of lymph from organs and tissues.
Initially, swelling appears, which eventually turns into elephantiasis. The legs of such children resemble the limbs of an elephant. Often girls under 35 years old suffer from this disease. A feature of the congenital form of elephantiasis is that two limbs are affected at once. The legs are most often affected.
The development of acquired elephantiasis is based on damage to the lymphatic vessels. All etiological factors can be divided into the following groups:
The patency of lymphatic vessels is impaired by tumors. Large benign and malignant neoplasms can compress blood vessels, leading to obstruction of lymph outflow. This pathology can develop against the background of radiation and after surgery. Elephantiasis can be a complication after removal of lymph nodes.
Among infectious causes, streptococcal infection is of greatest importance. Infection is possible with phlegmon or erysipelas. Bacteria penetrate the lymphatic vessels and disrupt the flow of lymph. The likelihood of developing elephantiasis is higher in individuals who have previously suffered several episodes of erysipelas.
The cause of elephantiasis is mechanical or thermal injury. Stagnation of lymph is observed after severe frostbite or burns of the extremities, as well as massive injuries. Lymphatic vessels are connected to veins in a certain way. The presence of varicose veins in the lower extremities in a person increases the risk of developing elephantiasis.
Other possible causes of elephantiasis include postthrombophlebitis syndrome and chronic venous insufficiency. Lymph stagnation in the upper extremities develops much less frequently. Women who have had an extended mastectomy (surgery for breast cancer) may face a similar problem. Other possible etiological factors for impaired lymph flow and the development of elephantiasis include lymphoma and prostate cancer.
In tropical countries, elephantiasis is often caused by a parasitic infection. Filariasis is of greatest importance in the development of this pathology. This is a group of diseases that are caused by parasitic roundworms. These parasites live and multiply in human lymphatic vessels. Such diseases are most common in residents of Africa, South America and South Asia.
High air temperatures are a favorable environment for the development of these parasites. More than 100 million people are infected with filaria. Elephantiasis often develops against the background of wuchereriosis and brugiosis.
Man is the final owner. These parasites can be carried by blood-sucking insects (mosquitoes). Mosquitoes are not common in our country. The larvae of the causative agents of wuchereriosis and brugiosis can be carried by mosquitoes. Adults parasitize human lymphatic vessels.
With filariasis, the following changes occur:
With brugiosis, elephantiasis of the legs or genitals is observed. Lymphatic vessels always become enlarged and inflamed.
Phlebologists often encounter elephantiasis in their patients.
Stagnation of lymph in the vessels and enlargement of the lower extremities can be a complication of chronic venous insufficiency, varicose veins and post-thrombophlebitis disease.
Chronic insufficiency of venous blood flow is a set of clinical symptoms caused by impaired blood flow in the veins.
In women, this pathology is detected much more often. In the absence of proper treatment, CVI (chronic venous insufficiency) leads to thrombosis of deep and superficial veins, which is a trigger for the development of elephantiasis. Risk factors for the development of CVI and varicose veins include constant static load, heavy lifting, physical inactivity, non-compliance with work and rest schedules, hereditary predisposition, poor nutrition, and smoking.
Thrombosis develops when the doctor’s recommendations are not followed, self-medication, or increased blood clotting. Against the background of thrombosis, some people develop postthrombophlebitis disease. It manifests itself as swelling of the limbs and can lead to lymph stagnation.
Treatment of patients with elephantiasis is carried out after instrumental and laboratory examination. Ultrasound of the veins of the lower extremities, rheovasography, duplex scanning of veins, radiography, thermography, MRI are organized. A blister test is often performed. Laboratory tests (microscopic examination, enzyme immunoassay, general blood test) must be organized.
Treatment can be conservative or surgical. It is aimed at normalizing lymph flow, restoring the patency of lymphatic vessels and the main cause of elephantiasis. When filariasis (brugiosis or wuchereriosis) is detected, Nemozol is used. Often, several anthelmintic drugs are used at once to kill roundworms.
Additionally, antibiotics (Doxycycline) and antihistamines are prescribed. If elephantiasis is a consequence of streptococcal infection, then the basis of treatment is antibiotics (Cefixime, Amoxiclav). To eliminate pain and inflammation, NSAIDs (Indomethacin, Butadione) are indicated. If necessary, glucocorticoids, angioprotectors and immunomodulators can be used.
For congenital lymphostasis, phlebotonics with a lymphotropic effect (Detralex, Phlebodia 600), antispasmodics, and diuretics are prescribed. Among homeopathic remedies, you can use Lymphomyosot. Regardless of the form of elephantiasis, treatment involves taking vitamins and biostimulants, performing manual lymphatic drainage massage, physiotherapy, physical therapy, following a diet, and wearing compression devices.
Hardware pneumocompression can be used. Patients are advised to swim, avoid standing or sitting for long periods of time, and practice Nordic walking. Proper hygienic foot care is of great importance. It is recommended to perform a hardware pedicure. Patients should limit their intake of table salt.
Surgical treatment is used only if drug therapy is ineffective. The goal of therapy is to ensure the drainage of lymphatic fluid.
Most often, lymphovenous anastomoses are performed; areas of skin are removed along with fascia and subcutaneous tissue. Sometimes liposuction is done. Tunneling is often performed. With severe varicose veins, sclerosis or removal of the vessel may be required. Thus, the development of elephantiasis is most often caused by infection, venous pathology and injury. The earlier treatment is started, the better the prognosis.
Elephantiasis of the feet is a disease, the development of which occurs against the background of disruption of the lymphatic system. Its danger lies in the fact that the damage extends not only to internal organs and all systems, but also to a person’s appearance. In the absence of timely treatment, the patient can be completely disfigured. This course of the pathological process can significantly reduce the patient’s quality of life.
In medical practice, the disease is called differently: elephantiasis, lymphodema, elephantiasis. In the human body, lymph is a liquid that is necessary for all tissues to cleanse waste, toxins and decay products. In addition, it promotes the formation of immunity and maintains fluid balance throughout the body, helping to transport blood to the internal organs. If a person has a problem with lymphatic drainage, they will have noticeable changes in their limbs. Let us consider in detail the causes and treatment of elephantiasis of the legs.
Like many diseases, elephantiasis does not occur without previous pathologies or other disorders. Stagnation of lymph can occur due to narrowing or blockage of the ducts. The disease can develop against the background of erysipelas of the lower extremities. The fact is that with this pathology, the patient has damage to the skin, through which pathogenic bacteria penetrate, and then they spread into the lymphatic vessels, which leads to inflammation, as well as a change in structure. As erysipelas progresses, the walls thicken, and this prevents the fluid from circulating normally.
The development of pathology can occur after surgery aimed at removing lymph nodes. This treatment also disrupts fluid circulation. The problem can arise with parasitic infestations, but in this case helminths must enter the body and affect the lymphatic vessels. The disease can also occur in people who have cancer metastases that tend to spread to a lymph node or vessel.
Swelling of the legs is a symptom of the disease
The initial stage of the pathology often goes unnoticed. The only thing a person may notice is the appearance of minor swelling in the foot or ankle area after daily exercise. They can also occur when standing for a long time, in hot weather and during the menstrual cycle. There is no pain, and the joint is fully functional. After the person rests, the swelling goes away. However, the constant progression of the disease leads to more obvious symptoms. Sometimes doctors detect a unilateral lesion, when elephantiasis appears on only one leg. The only exceptions are the congenital form of the pathology.
The first symptom of the disease is a feeling of fullness in the limbs, it is often accompanied by high fatigue, but even now there is no severe pain. Next, a person may notice that swelling has appeared on the foot, but just below the affected lymphatic vessel, then it spreads to the ankle, and then to the thigh. At this time, the skin becomes smooth and tense. To differentiate from cardiac or renal edema, you can press on the skin, which will allow you to see the hole that is absent with them.
Due to the fact that when lymphatic drainage is disrupted, pathogenic bacteria multiply in the skin, the lymph nodes begin to enlarge and become inflamed. If treatment is not started at this time, the patient will notice that the limb is hardening. At this stage, the fluid that is located in the muscle space, as well as subcutaneous fatty tissue, turns into connective tissue. Hard lumps appear in the legs, the skin does not gather in folds, and the hole no longer remains after pressure.
Changing the shape of the limbs
The limbs change their shape, and due to the fact that the bulges on the ankle are smoothed out, they become like a pillar or a cylinder. Lengthening of the legs is not observed, but the volume increases 3 times, while the diameter can reach 150 centimeters.
Atrophy of the sebaceous and sweat glands occurs, and then the epidermis becomes covered with warts, papillomas, ulcers, cracks and trophic ulcers. Bacterial allergies cause rashes. Due to the fact that too much lymph collects under the skin and has nowhere to go, fistulas appear on the epidermis through which a clear yellowish liquid oozes. Most often they are located in the folds between the fingers, because the skin is thinnest there. The skin acquires a brownish tint due to increased production of melanin.
Patients with elephantiasis should be treated only after a thorough instrumental and laboratory examination. Most often, doctors prescribe: ultrasound of the veins of the lower extremities, rheovasography, duplex scanning of veins, radiography, MRI. In some cases, a blister test is done. Laboratory tests and a general blood test are also required. Therapy can be conservative or surgical, but in any case, both methods aim to normalize lymph flow and restore the patency of lymphatic vessels.
If filariasis has been detected, then the patient is prescribed Nemozol. In advanced situations, doctors decide on the need to use several agents that can kill roundworms.
The complex also necessarily contains antibiotics and antihistamines. Most often it is Doxycycline. But if lymph stagnation occurs against the background of streptococcal infection, then Cefixime or Amoxiclav will be prescribed. In order to reduce pain and stop the inflammatory process, the patient is prescribed non-steroidal anti-inflammatory drugs, for example: Indomethacin or Butadione. In certain situations, glucocorticoids, angioprotectors and immunomodulators are prescribed.
If the form of the pathology is congenital, then the patient is advised to take phlebotonics that have a lymphotropic effect, for example: Detralex or Phlebodia 600. Antispasmodics and diuretics will also be prescribed. They may also be attributed to taking a homeopathic remedy such as Lymphomyosot.
When identifying elephantiasis in the legs, vitamins and biostimulants will be present in the complex of drug treatment; manual massage will also be required to increase lymph flow, physiotherapy, physical therapy, diet, and compression garments.
Doctors may also prescribe hardware pneumocompression. In this case, patients are advised to swim more, stand or sit as little as possible, and practice Nordic walking. It is necessary to pay great attention to foot hygiene, do a hardware pedicure, and reduce salt intake.
The goal of radical therapy is to ensure normal drainage of lymphatic fluid. Most often, patients undergo lymphovenous anastomoses, and also remove sections of the skin, along with the function and subcutaneous fat. In some cases, liposuction or tunneling is done. If the disease is accompanied by severe varicose veins, then the doctor may prescribe sclerotherapy or removal of the affected vessel.
If we talk about the prognosis for recovery, then everything will depend only on the stage at which the patient began treatment.
The disease “elephantiasis of the feet” has a more scientific name - lymphedema . This rather rare disease is characterized by serious changes in the human body. All this happens due to the fact that the normal outflow of lymph is disrupted. Its stagnation leads to the fact that all metabolic products remain in the tissue cells. Although in a normal situation they should have hatched.
This is all accompanied by swelling, changes in the shape of the limbs (they begin to resemble the legs of an elephant, which is why this disease began to be called that by the common people).
A disease such as elephantiasis of the legs can be caused by congenital pathologies of the lymphatic system, certain types of parasites, and bacteria. In more than 90% of cases, it appears on the lower part of the body. The remaining percentage is cases of disease affecting other parts of the body.
The first form of the disease can be caused by one of the following reasons:
These causative diseases are hereditary and lead to the appearance of elephantiasis on both lower extremities. According to statistics, it occurs mainly in adolescents and young women. The risk period is up to 35 years of age.
The causes of secondary elephantiasis of the legs are:
A disease such as elephantiasis is quite difficult to diagnose at first, because the main symptoms are only slight swelling in the ankle or foot area. They are more of a concern in the summer, when after a long walk in the heat your legs become very tired. In this case, the patient does not notice any pain.
Then the symptoms become more alarming. This is due to the fact that the disease progresses. At this stage, the following signs may appear:
Treatment of this disease can occur using both traditional and folk remedies.
People have several basic recipes for healing remedies that help normalize the functioning of the lymphatic system.
It is, of course, difficult to imagine what this remedy will taste like, but its usefulness is known to many healers. ? kg of garlic is crushed through a meat grinder or blender, after which 0.35 kg of honey is added to the resulting pulp. Mix and leave for a week. The recommended course of treatment is a month. Take a tablespoon of the product three times a day.
You can get rid of any parasites at home! You just need to drink it once a day.
No less original combination of products, but no less useful. Add a spoonful of chicory and a pinch of crushed dry ginger root to 200 ml of boiling water. Duration of treatment – 10 days.
Add a couple of tablespoons of crushed leaves to half a liter of boiling water. The liquid is infused for two hours, after which it is taken 100 ml four times a day.
The problem with the disease is that medications and folk remedies are effective only in the first stages of the disease. If stage 2 or 3 is diagnosed, surgical intervention is indispensable.
In many ways, the course depends on the reason. Antibiotics are often prescribed in combination with anti-inflammatory and antihistamine drugs.
It is worth noting that in addition to medications, in the initial stages of the disease, women are also recommended physical therapy, massage, and exercise therapy.
The most widespread due to their high efficiency are:
In the worst cases, surgery is performed. Its goal is to create new pathways for fluid outflow and, naturally, reduce the size of the problem area.
Elephantiasis is not such a common disease in post-Soviet territory. However, it is worth remembering that people who have suffered thrombophlebitis, frostbite and burns, and erysipelas are at increased risk. If you have the slightest doubt, it is best to contact a specialist to promptly monitor the situation.
The disease elephantiasis is characterized by pathological enlargement of the lower extremities due to impaired outflow of lymph and its stagnation. The muscles become saturated with proteins, which leads to fibrosis of the subcutaneous tissue.
Problems in genetics affect the formation of the entire human lymphatic system. Congenital diseases that predetermine the onset of the disease include:
The baby inside the womb may develop vascular dysplasia or abnormalities of the lymphatic system, which will cause excess lymph.
Women under 35 years of age are primarily at risk.
One of the most common causes of elephantiasis is filaria infection. These parasites infect the lymphatic system and subcutaneous tissue. As a result of their vital activity, the walls of blood vessels thicken, gradually becoming clogged, which leads to thrombosis and the impossibility of lymph outflow. The worms themselves form dense balls and also become a barrier.
Filaria are found in the southern tropics. Infection occurs through a mosquito bite.
Other causes of elephantiasis:
Another name is lymphedema. Characterized by slight swelling of the lower legs at the end of the day or during menstruation.
No pain or impairment of motor activity is observed. After rest, the limbs acquire a normal appearance. The skin is easily pulled back. This stage usually lasts a year.
The swelling becomes permanent, the skin turns blue, and palpation is painful. It is impossible to gather the skin into a fold. Convulsions appear. With fibroderma, the doctor notes the first compaction. Develops over 7 years.
The last stage is elephantiasis.
Elephantiasis of the feet has the following symptoms:
At the first appointment, the doctor collects anamnesis, asking the patient questions about:
Next, the specialist examines the existing symptoms to confirm the diagnosis and determine the stage of the disease:
Before prescribing treatment, the doctor must make sure that external signs are not caused by severe swelling associated with a disease of the internal organs. For this purpose, hardware research methods are used.
An X-ray contrast lymphogram is difficult to perform and harmful to health, and is prescribed only as a last resort if other tests have not confirmed the diagnosis.
The procedure is carried out as follows:
Elephantiasis is characterized by:
An analogue of the procedure is magnetic resonance angiography.
A quick and safe way to get a picture of lymphatic fluid circulation. Doppler ultrasound will show the following symptoms:
When testing blood, special attention is paid to the presence of antibodies to tropical helminths.
Microscopy shows the presence of filaria larvae in the bloodstream. Due to the specific behavior of parasites, this analysis is carried out only at night.
The rest of the time, you can do a “provocative” test: introducing a stimulating substance that causes filariae to enter the vessels.
Depending on the suspected cause of elephantiasis, it is necessary to contact specialists in different fields:
When prescribing treatment, the doctor pursues the following goals:
Effective in the first 2 stages of the disease and is carried out for:
The following drugs are usually given:
With the rapid development of elephantiasis of the legs or relapses of erysipelas, urgent help is needed for the body to create new pathways for the drainage of lymph.
The following steps are taken as preparation:
In medicine, there are several methods of surgical treatment of the disease. The surgeon chooses the appropriate one in each specific case, based on the stage, symptoms and the presence of underlying diseases:
After surgery, the load on the legs increases gradually. For rehabilitation, an additional course of antibiotics is prescribed and physiotherapy is prescribed.
The operation has contraindications:
Traditional methods cope well with the symptoms of elephantiasis in the initial stages, but they will not help cure it.
The causes and treatment of elephantiasis can only be determined by a specialist. Self-medication is strictly not recommended to avoid complications.
Elephantiasis can be easily prevented and treated in the early stages and without taking strong drugs. The approach must be comprehensive, and the recovery process must take place under the constant supervision of a doctor.
The following methods are used:
Therapeutic knitwear has a number of contraindications, so it is not recommended to start wearing it yourself.
In the early stages of development, elephantiasis responds well to treatment. But if cases of the disease have been recorded in the family, then both diagnosed patients and simply predisposed people need to carefully monitor their own health in order to take preventive measures in a timely manner.
Elephantiasis is an unpleasant disease of the lower extremities, expressed not only in loss of motor activity, but also in a repulsive appearance.
There is treatment, and it is better to start it early. If there are similar cases in the family, then the rest of its members need to carefully monitor their health and follow preventive measures.
A disease associated with disruption of normal lymph circulation, its stagnation in a certain part of the body - lymphedema, or elephantiasis. Changes in the size of the limbs and genitals with this disease change not only the appearance of a person, but also negatively affect his psyche.
The disease lasts a long time, treatment does not always lead to complete recovery, but at the same time it cannot be postponed, since the consequence of the disease can be not only elephantiasis of the legs, causing disability, the inability to move independently, but also sepsis. It occurs against the background of trophic ulcers and can be fatal.
It is believed that elephantiasis or elephantiasis is caused by helminths, filariae parasitizing in the human blood, they are also called nematodes. The direct causative agents of elephantiasis are Brugia malayi and Brugia timori, but symptoms of elephantiasis are much more often (95%) observed when infected with Wuchereria bancrofti, the causative agent of wuchereriosis.
This disease has other definitions - elephantiasis, elephantiasis or lymphedema
Elephantiasis disease or lymphatic filariasis is transmitted by the bite of a mosquito, which is not only a carrier, but also an intermediate host of filariae. Mature individuals become parasites in humans; they can be detected in the blood; it is better to take blood for analysis at night, since it is at this time that the filariae enter the bloodstream. There are subtypes that do not depend on circadian rhythms; they can be identified by taking blood samples during the day.
The causes of lymphostasis are inflammatory processes that occur when nematodes penetrate the lymphatic vessels; they clog the vessel, forming tangles in it. The lifespan of a sexually mature individual is 15-17 years.
According to various sources, up to 250 million people worldwide suffer from elephantiasis. It is usually found in women, with symptoms of lymphostasis appearing already in childhood, and active changes at a young age.
In addition, lymphedema can also be primary. This is a congenital defect of the lymphatic system that can lead to symptoms of elephantiasis. The reasons that contribute to the development of elephantiasis are different. Lymphostasis often occurs against the background of:
Therefore, despite the fact that the range of nematodes is tropical countries, symptoms of elephantiasis can be found in other regions. To prescribe adequate treatment, it is necessary to carry out differential diagnosis with these pathologies.
When a blood-sucking insect bites, the nematodes enter the bloodstream and spread throughout human tissues. It takes several months for them to develop into sexually mature individuals, so the incubation period for elephantiasis ranges from 3 months to one and a half years. Often the infection is asymptomatic and discovered by chance.
Elephantiasis can completely change a person and even disfigure him if correct treatment is not started in time
In other cases, the penetration of parasites into the lymphatic ducts, vessels, and lymph nodes of the body causes inflammatory reactions in them (lymphangitis, lymphadenitis). Another component of filaria parasitism is an allergic reaction to toxic substances produced by them.
The formation of tangles of intertwined parasites and inflammation are the causes of congestion in the lymphatic vessels, lymphostasis. Since lymph removes excess water, various metabolic products and waste products from tissues, disruption of its normal outflow contributes to the occurrence of edema and an inflammatory reaction. This is a favorable background for the development of concomitant infection.
Any inflammation is accompanied by increased activity of fibroblasts and the formation of connective tissue fibers, which enhance lymphostasis. Most often the lower extremities are affected, sometimes the lesion is unilateral.
There have also been cases of elephantiasis, in which changes affected the genitals, such as the scrotum. Congestion in it caused the development of hydrocele. When the face is affected, an enlargement of the upper eyelid is often observed.
At the end of the incubation period, the disease may occur unnoticed by humans. Symptoms are not pronounced; you can rarely notice a slight soft swelling in the affected area, which quickly goes away with exercise and resting with an elevated limb. Patients often report symptoms such as fatigue and pain in the legs.
Other symptoms, such as allergic rashes, pain along the lymphatic vessels, headache due to intoxication, occur in the acute period of lymphatic filariasis, due to the body's immune response to invasion. It is characterized by attacks with fever and inflammatory processes in the area of the lymph nodes. This condition lasts several days, attacks may recur periodically, but gradually the disease becomes chronic.
In the second stage of elephantiasis, deep damage to the lymphatic ducts and lymphostasis is observed. The patient develops swelling of the limbs, the swelling becomes dense to the touch, the size of the limb increases, but the swelling may subside if you keep the leg in an elevated position and sleep with a bolster.
During elephantiasis, there are three stages of the disease
Due to the increased formation of connective tissue, changes in the skin and thickening of the skin are observed. It becomes rougher and papillomatous changes, warts, and areas of hyperkeratosis form on it. When the genitals are affected, chyluria appears, and the urine takes on a whitish tint.
In the third stage of elephantiasis, swelling becomes permanent, changes during the day no longer go away, which is why this stage is called deforming. Elephantiasis of the legs appears more often, and lesions of the genitals, breasts and other parts of the body are less common.
Symptoms of elephantiasis are accompanied by changes in the skin, hyperplasia, and skin growth. The skin cracks and lymphatic fluid is released from wounds on the skin. Impaired blood supply and lymphostasis contribute to the formation of trophic ulcers and wounds. Their infection can lead to generalization of infection and sepsis.
Treatment of elephantiasis is carried out using conservative methods; surgical treatment is indicated for advanced forms of the disease or to eliminate complications. Elephantiasis needs to be treated comprehensively, for this purpose the following is carried out:
If there is a possibility of infection with filaria, and this means traveling to endemic areas, then you need to test your blood for their presence. Blood sampling is done at night, since some subtypes have a daily frequency of release into the vascular bed. Microscopic examination of blood cannot always identify the pathogen, so serological tests and PCR reactions are also used.
If filariasis is detected, drugs that destroy helminths are prescribed. A good effect is obtained when using drugs based on the recently discovered natural antibiotic avermectin.
Therapeutic massage, which is carried out both with hands and with the help of a special apparatus, is of great benefit at the initial stage of elephantiasis.
Treatment can be carried out with the antibiotic doxacycline, which indirectly destroys nematodes. It affects Wolbachia bacteria, which have a symbiotic relationship with the causative agent of elephantiasis. This causes the filariae to weaken and be destroyed.
It is difficult to treat elephantiasis in the later stages; patients often become disabled, therefore, in areas where the infection is widespread, prophylactic large-scale treatment is carried out with a single dose of two drugs, for example, Diethylcarbamazine and Albendazole.
Treatment of lymphostasis is carried out with medications, manual therapy and physiotherapy. A good effect is achieved by using lymphatic drainage, pneumatic massage, therapeutic and breathing exercises, and wearing special elastic underwear.
Lymphotonics drugs are also prescribed that improve lymphatic drainage, microcirculation, and restore vascular permeability (Eskuzan, Troxevasin, Ascorutin, Detralex).
The patient is prescribed a diet that limits the use of dairy products, beef, and tonic drinks (tea, coffee). It is advisable to exclude food additives, soda, alcohol and refined foods from the diet. Fruits and vegetables that accelerate metabolic processes and seasonings (ginger, cinnamon) are useful.
Treatment with folk remedies is carried out using decoctions of medicinal herbs (plantain, mint, echinacea). Psyllium seeds can be taken in powder or decoction form. Echinacea infusion is used both internally and externally. To improve the drainage function of the liver, decoctions of dandelion root and elecampane are useful. They can also be used to prepare compresses and lotions.
Elephantiasis is a dangerous disease that often leads to disability. Its widespread distribution requires not only prevention and adequate medical care for patients, but also the implementation of preventive measures aimed at eliminating the carrier of the infection.