Carme B, Gentilini M
J Mal Vasc. 1980;5(2):100-4.
Adult lymphatic filariae (Wuchereria bancrofti, Brugia malayi) can cause blocking of lymphatics producing obliterating endolymphitis lesions. The subsequent extravasation of lymph (or chyle when the obstruction is canal) is at the origin of the formation of lymphedema or elephantiasis, in which the main histological finding is great hypertrophy of collagen elements. This theory involving filaria only is not the full picture, and bacterial infection, mainly by streptococci, is an important factor. The association of filaria with microbes is particularly dangerous because the presence of the latter, or its toxins, causes death of local microfilariae and even adult worms, which are known to be more harmful dead than alive. The progression of the disease, especially in cases with lymphedema, which mainly affects the limbs and the genital organs, depends on three factors: the species of filaria, the degree of transmission, and the receptivity of the patient to the parasite. Large differences are found according to the region involved, and in the same endemic zone, according to the individuals affected. However, they almost always occur progressively in areas where there have been recurrent attacks of acute lymphangitis.
成年淋巴丝虫（班氏吴策线虫、马来布鲁线虫）可导致淋巴管阻塞，产生闭塞性淋巴管炎病变。随后淋巴液（当阻塞发生在乳糜管时为乳糜）外渗是淋巴水肿或象皮肿形成的根源，其主要组织学表现是胶原成分的显著肥大。仅涉及丝虫的这一理论并不全面，细菌感染，主要是链球菌感染，是一个重要因素。丝虫与微生物的联合尤其危险，因为后者或其毒素的存在会导致局部微丝蚴甚至成虫死亡，而众所周知，成虫死亡比存活时更具危害性。疾病的进展，尤其是在主要影响四肢和生殖器官的淋巴水肿病例中，取决于三个因素：丝虫种类、传播程度以及患者对寄生虫的易感性。根据受累区域不同，以及在同一流行区内根据受影响个体不同，会发现很大差异。然而，在急性淋巴管炎反复发作的地区，它们几乎总是渐进性发生。
