Lymphoscintigraphic analysis of lymphatic abnormalities in symptomatic and asymptomatic human filariasis.
To obtain high-resolution radionuclide lymphoscintigraphic images of affected limbs in persons with both symptomatic and asymptomatic filarial infection, 36 volunteers were recruited from a Wuchereria bancrofti-endemic area of Recife, Brazil, for a prospective, controlled analysis. Subjects were stratified after determination of serologic and clinical determinants of filarial infection status. Widespread lymphatic abnormalities were found in clinically asymptomatic microfilaremic persons, who had been assumed to have infection but not disease. All patients with clinical manifestations of lymphatic pathology and marked abnormalities. No correlation was found between clinical findings and actual lymphatic function as demonstrated by lymphoscintigraphy. The initial diagnosis of lymphatic filariasis, whether asymptomatic or symptomatic, is based on nonimaging laboratory criteria. After diagnosis, lymphoscintigraphy is a valuable tool for initial assessment of any lymphatic damage. Changes in strategies for therapeutic interventions in asymptomatic microfilaremic persons, who are not usually aggressively treated, may be warranted.
Freedman
D O
DO
Division of Geographic Medicine, University of Alabama at Birmingham 35294-2170.
de Almeida Filho
P J
PJ
Besh
S
S
Maia e Silva
M C
MC
Braga
C
C
Maciel
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D003911:Dextrans; D005368:Filariasis / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008208:Lymphatic System / Q000473:pathology / Q000503:physiopathology; D061305:Lymphoscintigraphy; D008875:Middle Aged; D015609:Organotechnetium Compounds; D012016:Reference Values; D014958:Wuchereria bancrofti
D003911:Dextrans; D015609:Organotechnetium Compounds; C034146:technetium Tc 99m dextran