DEAR DR. GOTT: When my husband was stationed in the Philippines, he contracted filariasis, which was diagnosed after seeing dozens and dozens of doctors over 18 years. Can the disease affect his kidneys and other organs of the body? He knows it has already damaged his lymph nodes. Any information you can give on this subject will be appreciated.
DEAR READER: It appears your husband was diagnosed with lymphatic filariasis, a parasitic infection from filarial worms that are threadlike in appearance and common in the tropics. Only the adult worms live in the human lymphatic system. There are three species of filarial parasites that inhabit the human lymphatic system. Each has distinct differences in appearance and calls for different treatment. All three can cause significant dermal damage, with the major symptom affecting the lymphatic system.
Filariasis is spread from person to person through mosquito bites. Tiny worms circulate through the person’s bloodstream. When the mosquito bites, it ingests these worms and ultimately becomes infected. That insect can then pass the disease on to other people. The worms pass from the mosquito through the skin and into the lymph vessels, where they grow into adults. The adult worm has a life expectancy of up to seven years (rarely longer). During this time, the adult worms mate and release millions more microscopic worms into the blood. People with the worms in their bloodstream can pass the infection to others through mosquito bites.
According to the World Health Organization, about 120 million people are affected in tropical and subtropical areas of the world. They go on to say, “The vast majority of infected people are asymptomatic, but virtually all of them have subclinical lymphatic damage, and as many as 40 percent have kidney damage, with proteinuria and haematuria.” Proteinuria is the presence of protein in the urine; haematuria is the presence of blood in the urine. So, to answer to your question, a person’s kidneys can be damaged. Both conditions are treatable. Travelers should keep in mind that it takes repeated bites over months or even years to get lymphatic filariasis. Those visiting the tropics short term are at extremely low risk.
A compromised lymphatic system can lead to lymphedema, which might be reversible in its initial stages; however, acute stages can become irreversible, leading to chronic elephantiasis of the arms and legs, genitalia and breasts. Patients may have abscesses, ulcers, pleural effusions, pericarditis and more.
Annual treatment can be coordinated with DEC (diethylcarbamazine) and ivermectin, either drug alone or through the daily use of DEC-fortified salt. Treating chronic lymphedema and elephantiasis aggressively can reverse symptoms dramatically. Patients with heavily damaged extremities might benefit from surgical decompression of the lymphatic system through surgery.
If you finally found a physician that put the pieces of your husband’s time in the Philippines and his symptoms together and came up with the correct diagnosis, I strongly urge you to follow his or her recommendations. Your doctor sounds like a winner.
To provide related information, I am sending you a copy of my Health Report “Kidney Disorders.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order payable to Newsletter and mailed to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.
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