Partono F
Ciba Found Symp. 1987;127:15-31. doi: 10.1002/9780470513446.ch3.
Lymphatic filariasis affects predominantly the poorer sector of a community, who can least afford to have the disease. According to an estimate by the World Health Organization in 1984, more than 90 million people are currently infected. It is postulated that the different disease manifestations of filariasis are caused by different host immune responses. An understanding of the clinical spectrum of lymphatic filariasis is essential for the effective treatment and control of the disease, and for correctly correlating clinical status with host immune responses. The disease should be divided into lymphatic filariasis caused by adult worms and occult filariasis due to hyper-responsiveness of the host against microfilariae. The acute stage of filariasis is characterized by episodic adenolymphangitis, followed by obstructive lesions one or more decades later. In brugian filariasis, adenolymphangitis is most commonly observed at the inguinal region, and elephantiasis predominantly involves the leg below the knee. In bancroftian filariasis, the lymphatics of the male genitalia are frequently affected, leading to epididymo-orchitis and hydrocele. Lymphatic filariasis runs an accelerated clinical course in previously unexposed adult migrants. Occult filariasis is not a disease of public health importance. It is characterized by lymphadenopathy, asthmatic bronchitis, hypereosinophilia, and an increase in the production of antibodies, especially immunoglobulin, against microfilarial antigens.
淋巴丝虫病主要影响社区中最贫困的人群，他们最无力承担患这种疾病的后果。据世界卫生组织1984年估计，目前有超过9000万人感染。据推测，丝虫病不同的疾病表现是由不同的宿主免疫反应引起的。了解淋巴丝虫病的临床谱对于有效治疗和控制该疾病，以及正确关联临床状况与宿主免疫反应至关重要。该疾病应分为由成虫引起的淋巴丝虫病和由于宿主对微丝蚴超敏反应导致的隐性丝虫病。丝虫病的急性期以发作性腺淋巴管炎为特征，随后在一二十年后出现阻塞性病变。在布鲁氏丝虫病中，腺淋巴管炎最常见于腹股沟区，象皮肿主要累及膝盖以下的腿部。在班氏丝虫病中，男性生殖器的淋巴管经常受到影响，导致附睾炎和鞘膜积液。在以前未接触过的成年移民中，淋巴丝虫病的临床病程会加速。隐性丝虫病对公共卫生并不重要。其特征为淋巴结病、哮喘性支气管炎、嗜酸性粒细胞增多，以及针对微丝蚴抗原的抗体尤其是免疫球蛋白产生增加。
