Filariasis natural history, complications and prognosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Mohammed Abdelwahed M.D[2]

If left untreated, patients with lymphatic filariasis may progress to develop lymphatic dilation and impaired lymphatic drainage. Common complications of filariasis include chronic lymphedema, hydrocele, skin pigmentation, and renal impairment like chyluria. Prognosis is generally good in early cases, but in chronic cases the disease can leave an individual severely disabled with genital damage.

Lymphatic filariasis can be asymptomatic or symptomatic. Symptoms may include acute adenolymphangitis, filarial fever, and tropical pulmonary eosinophilia. If left untreated, disease can progress to lymphatic dilatation, abnormalities in lymphatic drainage, and microscopic hematuria and proteinuria.

Complications that may develop as a result of lymphatic filariasis include:

• Lymphedema:
  • Lymphedema refers to non-pitting edema in limbs due to chronic inflammation and obstruction of lymphatic vessels.
  • Lymphedema commonly occurs in upper limbs and may involve breasts.
  • Lower limb is a common place for lymphedema that commonly spares genitalia except W.bancrofti endemic areas.^[1]
• Hydrocele:
  • Hydrocele was also reported up to 30 cm in diameter due to lymphedema in the genitalia that may lead to bacterial infection.
  • Some cases of filariasis of the ovary and mesosalpinx were also reported.^[2]
• Renal involvement:
  • Increased intestinal lymph drainage in renal vessels causes loss of lymph fluid in urine giving it milky appearance.^[3]

• Early or mild filariasis, including acute inflammatory episodes, typically responds well to treatment.
• It can be reduced and prevented with simple measures of hygiene, skin care, exercise, and elevation of affected limbs, chronic infection does not.
• Filariasis does not commonly lead to mortality, however, disease can leave an individual severely disabled with genital damage or elephantiasis.
• Lymphatic filariasis is the second leading cause of disability worldwide with 40 million persons suffering from complications that limit occupational activities, educational and employment opportunities, and mobility.^[4]

Template:WSTemplate:WH