title: Near-Infrared Fluorescence Lymphatic Imaging of a Toddler With Congenital Lymphedema.
abstract: Primary lymphedema in the pediatric population remains poorly diagnosed and misunderstood due to a lack of information on the causation and underlying anatomy of the lymphatic system. Consequently, therapeutic protocols for pediatric patients remain sparse and with little evidence to support them. In an effort to better understand the causation of primary pediatric lymphedema and to better inform clinical care, we report the use of near-infrared fluorescence lymphatic imaging on the extremities of an alert, 21-month-old boy who presented with unilateral right arm and hand lymphedema at birth. The imaging results indicated an intact, apparently normal lymphatic anatomy with no obvious malformation, but with decreased lymphatic contractile function of the affected upper extremity relative to the contralateral and lower extremities. We hypothesized that the lack of contraction of the lymphatic vessels rather than an anatomic malformation was the source of the unilateral extremity swelling, and that compression and manual lymphatic drainage could be effective treatments.
authors.affiliation: Vascular Anomalies Clinic, Division of Pediatric Plastic Surgery, Department of Pediatric Surgery and.
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Greives
authors.affiliation: Brown Foundation Institute of Molecular Medicine for the Prevention of Human Diseases, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas.
authors.forename: Melissa B
authors.initials: MB
authors.lastname: Aldrich
authors.affiliation: Brown Foundation Institute of Molecular Medicine for the Prevention of Human Diseases, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas.
authors.forename: Eva M
authors.initials: EM
authors.lastname: Sevick-Muraca
authors.affiliation: Brown Foundation Institute of Molecular Medicine for the Prevention of Human Diseases, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas john.rasmussen@uth.tmc.edu.
authors.forename: John C
authors.initials: JC
authors.lastname: Rasmussen
mesh_terms: D006801:Humans; D007223:Infant; D042601:Lymphatic Vessels / Q000000981:diagnostic imaging*; D008209:Lymphedema / Q000000981:diagnostic imaging*; D008297:Male; D061848:Optical Imaging / Q000379:methods*