Nephropathy in Lymphatic Filariasis

Lymphatic filariasis (LF) is a neglected tropical disease with severe consequences of functional disability and deformity in affected patients. The severity of the manifestations increases with age, and chronic lesions such as elephantiasis may become irreversible, causing disability and exposing affected individuals to social prejudice. LF can cause glomerular lesions, with one of the characteristics being the deposition of immune complexes, but also showing tubulointerstitial involvement. LF can have different clinical forms, from absence of symptoms to acute and chronic manifestations. The acute manifestations of LF, especially those caused by W. bancrofti, a species of interest in Brazil, are characterized by episodes of adenolymphangitis associated with fever and malaise. In men, this adenolymphangitis can be located in the genitals, presenting as acute orchiepididymitis. The chronic manifestations are especially important due to the limiting and stigmatizing patient characteristics. The clinical presentation depends on the location of the lymphatic damage. The best known is the lymphedema, which initially shows to be soft and progresses to hard and extensive edema, especially of the lower limbs. The diagnosis is based on specific findings described below and may be aided by nonspecific laboratory findings, such as eosinophilia, increased serum IgE levels, microscopic hematuria, and proteinuria. Treatment of LF is indicated for all individuals with active infection, regardless of whether or not they have clinical manifestations associated with the presence of the parasite.