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elephantiasis (ĕlˈəfăntīˈəsĭs), abnormal enlargement of any part of the body due to obstruction of the lymphatic channels in the area (see lymphatic system), usually affecting the arms, legs, or external genitals. In tropical countries the most common cause is filariasis, infestation with certain filaria, small parasitic roundworms (see worm) of the genera Wuchereria bancrofti or Brugia malayi that are introduced into the body by many species of mosquitoes. The adult worms live in the lymphatic system, causing local inflammation, fibrosis, and obstruction, and resulting in the characteristic enlargement and thickening of the skin. The initial damage done by the worms can be greatly worsened by secondary bacterial and fungal infections.
Recovery from filariasis is possible and surgery sometimes helps, but any elephantiasis that develops during the disease cannot be cured. Ivermectin, an antifilarial drug, has been effective with a single dose. Diethylcarbamazine often kills the adult worms or impairs their reproductive capabilities, and the antibiotic doxycycline, which works by killing symbiotic bacteria that live inside the worms, also eliminates adult worms. Albendazole, in combination with others drugs, is being used in a program of mass drug administration undertaken under the auspices of the World Health Organization in an attempt to eliminate filariasis. Begun in 1999 the program treats an entire population in an attempt to eradicate the worm. Control of mosquitoes also is instrumental in holding down the incidence of the disease. Careful hygiene and other measures that prevent and control subsequent bacterial and fungal infections in limbs or genitals in which the lymphatic system has been damaged can reduce disfigurement and suffering. Blocking of the lymph channels and elephantiasis can also result from lymphogranuloma venereum, a sexually transmitted disease, and from podoconiosis, an abnormal inflammatory response to recurring barefoot exposure to irritant mineral particles in certain volcanic soils.
a disease of man and some animal species, manifested by a progessive thickening of the skin and subcutaneous tissue resulting from chronic lymphatic obstruction and lymphatic edema. Elephantiasis is caused by a congenital, hereditary, or acquired insufficiency of the lymphatics, with accompanying impairment of lymph dynamics—the absorption of lymph through the lymph capillaries and the flow of lymph through the lymphatic system.
In man, elephantiasis affects mainly the lower extremities. The disease’s onset is marked by slight, painless edema of the foot or ankle joint that disappears when the extremity is elevated. The edema gradually spreads upward, persisting and becoming firmer to the touch if the patient remains confined in bed over a lengthy period. The leg becomes deformed, resembling that of an elephant. Except for a sensation of heaviness in the leg, pain is generally absent. Elephantiasis must be distinguished from edemas and thickenings of the lower extremities arising from such disorders as chronic venous insufficiency, obesity, endocrine disturbances, and tumors.
Treatment at the onset of the disease is conservative: elastic stockings or bandages are worn, regular massage is administered, and the extremity is kept elevated. Surgical treatment of advanced elephantiasis is effective in 85 percent of the cases.
Elephantiasis occurs in horses and some breeds of swine. The inflammatory process that caused the disease is treated.
REFERENCEGorshkov, S. Z., and G. G. Karavanov. Slonovost’. Moscow, 1972.
S. Z. GORSHKOV