Elephantiasis: symptoms, causes and treatments

There are a large number of diseases and disorders in the world, many of which are largely unknown. for most of the world or they tend to be strange given their low prevalence in our countries of origin.

However, some of them cause physiological alterations that are evident to the naked eye, something that makes some existing cases stand out and are recognized or remembered. This is what happens with elephantiasis, also known as lymphatic filiarisis (although elephantiasis would refer more to the symptom in question, they are often identified as synonyms).

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What is Elephantiasis?

We understand by elephantisasis the presence of a marked and evident swelling and thickening of the tissues that appears as a consequence of a blockage of the lymphatic system, which stops draining the lymph. It is the third phase of a lymphedema, in which the alterations become permanent. It usually appears in the chronic phase of lymphatic filariasis, to the point that lymphatic filariasis and elephantiasis are often identified and used synonymously. Generally, the thickening is produced in the legs or arms, and involvement of the genitals and breasts is also frequent. On many occasions it can cause pain in those who suffer from it. The renal and immune systems are also often affected, as are the bones.

Deformities caused by this disorder can have serious consequences. For people who suffer from it, the appearance of fistulas, wounds with the possibility of infection or even the appearance of tumors is not uncommon. At a functional level, it can also profoundly alter a person's life, being able to alter and even make it impossible to walk or move, being a frequent reason for disability physical. If it occurs in the genitals, it also alters sexual functionality.

The parasitic infection that generates it usually starts in children, although in most cases the symptoms begin to be observed in adulthood. Said infection, in fact, can remain asymptomatic despite damage to the lymphatic system.

Likewise, these alterations are usually a reason for great embarrassment and discomfort for those affected, many of them shying away from social contact and isolating themselves. In fact, even the term elephantiasis (which compares the legs of those affected with those of an elephant), can already be a source of stigma for them. Social and work life are profoundly impaired as an indirect effect, and the appearance of malaise, depression and anxiety is not uncommon.

Is about a tropical disease mainly present in countries in Africa, South America, Central America or Indonesia. Although it may seem like a strange disease to us and it is easy to think that it is classifiable among rare diseases and little frequent, the truth is that it is more common than it seems: around 120 million people suffer from some form of this disturbance. However, it is a disease little taken into account at a general level, having been neglected research regarding its treatment for years.

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stages of appearance

It is possible to identify three phases in which elephantiasis gradually occurs. Technically, the name of elephantiasis corresponds to the third or last phase of the process, evolving the lymphedema (edema generated by lymph) in the process until reaching a chronic phase.

1. Post-bite edema

The first moment to take into account is the appearance of the mosquito bite that transfers the filaria. Initially, no symptoms may appear at all. In cases where it does occur, a palpable swelling is usually observed in the affected area, which gradually increases. In the morning the swelling is imperceptible, but it reappears throughout the day. The skin is still soft.

2. Second phase: progression of lymphedema

In a second phase, the swelling has been increasing and is perceptible at all times, although it still seems to reduce in the morning (something that it will no longer do over time). The skin begins to harden little by little.

3. Elephantiasis

Third and final phase, in which the swelling problem becomes irreversible and acquires a characteristic hardness. The level of swelling may increase, and the morphological changes will be permanent.

Causes of this disease

Elephantiasis is a problem that can have different causes, although the most common is infection by parasitic worms known as filarial worms. This parasite blocks the lymphatic system, something that generates edema or fluid accumulation in different areas of the body. Specifically, the most common is the Wucheria bancrofti, although there are other species that also generate this disease. The parasite usually comes into contact with our body through the bite of mosquitoes such as Anopheles and culex, passing the infection from the blood to the lymphatic system (where the parasites feed and grow).

However, although elephantiasis is generally produced for this reason, sometimes they can also alterations that end up generating elephantiasis (if we understand it as a symptom and not as a disorder in Yeah). We would then be talking about non-filarian elephantiasis, caused by other lesions such as some typical of the metastasis of some tumors, other diseases or the consequences of surgery that damaged the lymphatic system.

Treatments

The disease that causes elephantiasis can fortunately be treated by the use of different drugs and antiparasitics, especially in an acute and initial phase. Among the most used and effective is usually ivermectin or diethylcarbamazine. The use of antibiotics and analgesics may also be required to combat infections and pain, common in this disease.

It must be taken into account that even if the parasites are killed, the malformations present in the chronic phase (that is, the extreme swelling of the affected parts) can remain for life. There are procedures such as compression therapies and surgery that can reverse the swelling, although the use of compression mechanisms will be necessary. Drainage or diversion of excess lymph can also be of great help.. In these cases, compressive measures, establishment of hygienic guidelines to avoid infections and physiotherapy may be useful.

Although treatable, it is necessary to take into account the need to establish prevention plans. Hygiene and mosquito avoidance using mosquito nets or insecticides can help prevent this evil, traditionally little attended to worldwide (although the WHO has put a global program for the elimination of lymphatic filariasis is underway, which is expected to achieve success in approximately the year 2020).

Bibliographic references:

• Lozano, Y. (2009). Elephantiasis. Due to one case. Electronic Medical Journal, 31 (3). Matanzas, Cuba.
• Fenwick, A. (2012). The global burden of neglected tropical diseases. Public health, 126 (3): 233-236.
• Fortuny, E.I.; Guerreiro, M.F.; Pereira, J.M. (2014). Is Lymphedema reversible? Rev. Chilean Dermatol.; 30 (4) .