There are a large number of diseases and disorders in the world, many of which are largely unknown to most of the world or 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 be 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 frequently identified as synonyms).
By elephantisasis we understand the presence of a marked and obvious swelling and thickening of the tissues that appears as a result of a blockage of the lymphatic system, which stops draining lymph. This is the third phase of 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 occurs in the legs or arms, and the genitals and breasts are also frequently affected. On many occasions it can cause pain in those who suffer from it. The kidney and immune systems are also often damaged, as well as the bones.
The 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 unusual. At a functional level, it can also profoundly alter a person’s life, potentially altering or even making it impossible to walk or move, being a common cause of physical disability. If it occurs in the genitals, it also alters sexual functionality.
The parasitic infection that causes it usually begins in childhood, although in most cases the symptoms begin to be observed in adulthood. This infection, in fact, can remain asymptomatic despite damage being caused to the lymphatic system.
Likewise, these alterations tend to be a cause of great shame and discomfort for those affected, with many of them avoiding 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 affected as an indirect effect, and the appearance of discomfort, 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 can be classified among rare and uncommon diseases, the truth is that it is more common than it seems: around 120 million people suffer from some form of this alteration. However, it is a disease that is little taken into account at a general level, with research regarding its treatment having been neglected for years.
Stages of appearance
It is possible to identify three phases in which elephantiasis gradually occurs. Technically, the name elephantiasis would correspond to the third or last phase of the process, lymphedema (edema generated by lymph) evolving in the process until reaching a chronic phase.
1. Post-sting edema
The first moment to take into account is the appearance of the mosquito bite that transfers the filaria. Initially, no symptoms may appear. In cases where it does occur, palpable swelling is usually observed in the affected area, which will gradually increase. In the mornings, the swelling is imperceptible, but it reappears throughout the day The skin is still soft.
In a second phase, the swelling has been increasing and is noticeable at all times, although it still seems to reduce in the mornings (something it will stop doing 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 are going to 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 filariae This parasite blocks the lymphatic system, something that generates edema or fluid accumulation in different areas of the body. Specifically, the most common is Wucheria bancrofti, although there are other species that also cause 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 caused by this reason, sometimes alterations can also occur that end up generating elephantiasis (if we understand it as a symptom and not as a disorder itself). We would then be talking about non-filarian elephantiasis caused by other injuries such as some typical of the metastasis of some tumors, other diseases or the consequences of a surgery that damages the lymphatic system.
Treatments
Fortunately, the disease that causes elephantiasis can be treated by the use of different drugs and antiparasitics, especially in an acute and initial phase. Among the most used and effective are 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, extreme swelling of the affected parts) can remain for life. There are procedures such as compression therapies and surgery that can reverse 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 physical therapy 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 avoid this disease, which has traditionally been poorly attended to worldwide (although the WHO has launched a global program for the elimination of lymphatic filariasis that is expected to be successful around the year 2020).
