Extralymphatic disease due to bancroftian filariasis

Abstract

Infection with Wuchereria bancrofti, Brugia malayi, or B. timori not only affects the structure and function of lymphatic vessels but is also associated with extralymphatic pathology and disease. Because it is now possible to detect living adult worms by ultrasonography, much emphasis is placed on lymphatic pathology. However, the finding of renal damage in asymptomatic microfilaremic carriers has led to increased recognition of the importance of extralymphatic clinical manifestation in bancroftian filariasis. The authors present a number of clinical syndromes that may be manifestations of extralymphatic filarial disease and discuss possible mechanisms that cause these conditions. The main purpose of this paper is to raise the awareness of students and physicians of the prevalence and the importance of extralymphatic disease in bancroftian filariasis so that it is diagnosed and treated properly and also to alert for the need of additional research in this area.

Disseminated Microfilaremia Associated with Lung Cyst and Empyema: An Autopsy Report

“…There were eosinophilic abscesses within the interstitium, and microfilariae were noted both within the glomerular capillaries and in the abscesses. Although the patient did not have any renal symptoms, microscopic hematuria and proteinuria have been documented in 45% of untreated microfilaremic patients [1]. Both deposition of immune complexes in the glomerular basement membrane and mechanical damage to glomeruli by circulating microfilariae are believed to account for the hematuria in these cases [10].…”

“…Besides, the well documented lymphatic manifestations, the larval forms of W. bancrofti, Brugia malayi, and Brugia timori are also associated with extralymphatic pathology and disease. Reports of extralymphatic manifestations producing end organ damage due to microfilariae of W. bancrofti have been documented in the literature [1,3].…”

“…Unlike lymphatic disease syndromes, the extralymphatic manifestations of bancroftian filariasis are not caused by the adult worm per se, but by microfilariae, by diffusible products from yet undefined parasite stages, or by immune complexes [1]. We have encountered an autopsy case of disseminated microfilaremia due to bancroftian filariasis accompanied by a lung cyst and empyema in a young Indian man.…”

Mudanças de paradigmas na filariose bancroftiana

“…Neste trabalho de revisão, será dada ênfase às alterações no vaso linfático e no linfonodo (chamadas de manifestações linfáticas). As manifestações extralinfáticas causadas pelas microfilárias podem ser encontradas em artigo de revisão que inclui a descrição em detalhes da forma respiratória rara chamada de eosinofilia pulmonar tropical 9 . A utilização de duas ferramentas de diagnóstico em filariose bancroftiana contribuiu sobremodo para a geração de novos conhecimentos dessa parasitose.…”

Worm under the Skin—An Unusal Case of Filariasis

“…Repeated attacks of lymphangitis leads to destruction of lymphatic vessels which results in the most common and dramatic chronic presentation, elephantiasis. An article by Dreyer et al [9] mentions the rare extraly mphatic syndromes associated with filariasis. This included arthritis, glomerulonephritis, tropical pulmonary eosinophilia, microfilarial granulomata and filarial splenomegaly.…”