Acute attacks in the extremities of persons living in an area endemic for bancroftian filariasis: differentiation of two syndromes

Dreyer, Gerusa; Medeiros, Zulma; Netto, Maria José; Leal, Nilma Cintra; Castro, Luiz Gonzaga de; Piessens, Willy F.

doi:10.1016/s0035-9203(99)90140-2

Cited by 128 publications

(99 citation statements)

References 13 publications

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“…Meanwhile, failure to treat the disease results in recurrent acute febrile attacks and progressive damage to the lymphatic system. Without access to simple hygiene practices, infected subjects are unable to prevent further progression of the outwardly visible complications of LF [17]. As the disease progresses, both labor productivity and sexual reproductive potential are increasingly hampered [11].…”

Section: The Social Impact Of Disease On Individuals and Productivitymentioning

confidence: 99%

Filarial hydrocele: a neglected condition of a neglected tropical disease

Otabil¹,

Tenkorang²

2015

J Infect Dev Ctries

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Filarial hydrocele is the most common chronic manifestation of lymphatic filariasis (LF) and poses a major public health burden to several filarial endemic countries. This review highlights the socio-economic impact of the disease, the role of the immune system in hydrocele development, current diagnostic approaches, and the control and management of filarial hydrocele. In the quest to facilitate the global effort to eliminate filarial hydrocele as a neglected tropical disease, a more comprehensive understanding of the mechanisms underlying the pathogenesis and development of the condition is important. In general, success has been achieved using annual treatment with ivermectin, but much remains to be done, particularly with late-stage infected individuals where surgery remains the only option. Studies have successfully demonstrated that inhibition of embryogenesis in adult female worms occurs after weeks of tetracycline treatment. Even more intriguing was the observation that the Wolbachia endosymbionts potently induce proinflammatory cytokines such as tumor necrosis factors (TNFs) and vascular endothelial growth factors (VEGFs), which are crucial for the development of filarial hydrocele. Furthermore, reports from human studies show that doxycycline treatment significantly ameliorates filarial hydrocele and markedly reverses early-stage filarial hydrocele. However, with the enormous challenges that face LF elimination such as global funding, logistics, civil wars, and drug resistance, a more relentless and collective approach from local governments as well as other stakeholders is needed to accelerate the fight against filarial hydrocele if the goal to eliminate it by 2020 is be to achieved.

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Section: The Social Impact Of Disease On Individuals and Productivitymentioning

confidence: 99%

Filarial hydrocele: a neglected condition of a neglected tropical disease

Otabil¹,

Tenkorang²

2015

J Infect Dev Ctries

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“…Ocorrem após o uso da DEC 16 21 31 32 51 e não são observadas com a ivermectina quando administrada isoladamente 15 24 . O processo é conhecido como linfangite filarial aguda (LFA), similar ao que ocorre na morte natural (não induzida por droga) dos parasitas adultos 21 . Os pacientes podem ser assintomáticos ou apresentar queixa de dor, geralmente de pouca intensidade, no local ou nas proximidades onde ocorreu a morte dos vermes.…”

Section: Tratamento Quimioterápico Antifilarialunclassified

Recomendações para o tratamento da filariose bancroftiana, na infecção e na doença

Dreyer

Norões

2002

Rev. Soc. Bras. Med. Trop.

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Resumo As bases para se instituir o tratamento da filariose linfática são: prevenir, reverter ou diminuir a progressão da doença e interromper a transmissão do parasita. A escolha das medidas mais adequadas para o tratamento dos pacientes portadores de filariose linfática requer o conhecimento das diversas manifestações clínicas, assim como os seus diferentes mecanismos patogênicos. No passado, o tratamento da filariose era baseado somente na prescrição da droga antifilarial, porém, para os pacientes apresentando as manifestações agudas ou crônicas da doença, é imperativo que outras medidas sejam indicadas, incluindo higiene e dieta. Assim, essa nova visão multidisciplinar terapêutica é tão ou mais importante do que o início imediato da terapia antifilarial. Independentemente da manifestação clínica do paciente, três componentes estão agora indicados: 1) os cuidados clínicos e higiênico-dietéticos específicos para as diversas manifestações clínicas, 2) a educação e o suporte psicológico e finalmente 3) o tratamento quimioterápico com a dietilcarbamazina (DEC) ou a combinação de DEC e ivermectina. Os autores descrevem também as eficácias relativas macro e microfilaricidas da dietilcarbamazina e da ivermectina sozinhas ou em combinação usadas em programas de tratamento em massa para interrupção da transmissão e comentam sobre a introdução do uso da higiene em programas de saúde pública para a prevenção do linfedema. Palavras-chaves: Controle. Tratamento. Dietilcarbamazina. Ivermectina. Bancroftose. Elefantíase.Abstract The goals of treatment for lymphatic filariasis are: to prevent, reverse, or halt progression of disease; and to interrupt transmission of the parasite. Selecting the appropriate therapy for the patient with lymphatic filariasis requires knowledge of the various clinical features of filarial disease and their pathogenesis. In the past, treatment of lymphatic filariasis has focused primarily on antiparasitic chemotherapy; however, for many of the acute and chronic manifestations of lymphatic filariasis, it is now clear that supportive or other forms of clinical care are even more important than antiparasitic medication in order to prevent worsening of the disease. Regardless of the clinical manifestations of filarial disease in a particular patient, the following three components of treatment should, in general, be considered: supportive or disease-specific clinical care (including higiene and diet), patient education and counseling and finally, antiparasitic chemotherapy with diethylcarbamazine (DEC) and/or the combination of DEC with ivermectin. The authors also describe the proportional efficacy of diethylcarbamazine and ivermectin, alone or in combination, for use in mass treatment aiming at transmission interruption and the use of hygiene as a public health approach for lymphedema prevention. Key-words: Control. Treatment. Diethylcarbamazine. Ivermectin. Bancroftian filariasis. Elephantiasis. Nos últimos anos, a filariose linfática tem surgido como um problema crescente em saúde pública em vária...

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“…5 Disease associated with LF infection in children, however, is poorly understood. Although case reports attest to the occurrence in some children of the same LF manifestations commonly recognized in adults (e.g., elephantiasis, 6 hydrocele, 7 tropical pulmonary eosinophilia 8 ), these manifestations are not as frequent in children as they are in adults. Other non-pathognomonic syndromes have also been suggested as clinical presentations for LF in children (including adenopathy, fever, arthropathy), but specific techniques to establish the etiology of these presentations have been lacking.…”

Section: Introductionmentioning

confidence: 97%

Lymphatic filariasis in children: adenopathy and its evolution in two young girls.

Dreyer

Figuerêdo-Silva²,

Carvalho³

et al. 2001

The American Journal of Tropical Medicine and Hygiene

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Abstract. Lymphatic filariasis is a widespread infectious disease of children in endemic areas, but little is known about the early lymphatic damage in children and its evolution, either with or without treatment. Two girls (ages 6 and 12 years) from a Wuchereria bancrofti endemic region of Brazil presented with chronic inguinal adenopathy. Neither had microfilaremia. By ultrasound both were shown to have living adult worms in their enlarged inguinal nodes and had occult local lymphatic damage (lymphangiectasis). One girl spontaneously developed acute adenitis in the affected node prior to any intervention; this adenitis resolved within 10 days and was associated with the progressive disappearance over 45-90 days of all local abnormalities detectable by ultrasound. In the other child, after treatment with a single dose of diethylcarbamazine (DEC), the same clinical picture of transient adenitis and resolving abnormalities (detectable by ultrasound) occurred. These findings demonstrated filariasis as the cause of adenopathy in children, and also both spontaneous and treatment-induced worm-death, with subsequent reversal of lymphatic abnormalities.

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Acute attacks in the extremities of persons living in an area endemic for bancroftian filariasis: differentiation of two syndromes

Cited by 128 publications

References 13 publications

Filarial hydrocele: a neglected condition of a neglected tropical disease

Filarial hydrocele: a neglected condition of a neglected tropical disease

Recomendações para o tratamento da filariose bancroftiana, na infecção e na doença

Lymphatic filariasis in children: adenopathy and its evolution in two young girls.

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