LYMPHOSCINTIGRAPHIC ANALYSIS OF LYMPHATIC ABNORMALITIES IN SYMPTOMATIC AND ASYMPTOMATIC HUMAN FILARIASIS

To obtain high-resolution radionuclide lymphoscintigraphic images of a ffected limbs in persons with both symptomatic and asymptomatic filari al infection, 36 volunteers were recruited from a Wuchereria bancrofti -endemic area of Recife, Brazil, for a prospective, controlled analysi s. Subjects were stratified after determination of serologic and clini cal determinants of filarial infection status. Widespread lymphatic ab normalities were found in clinically asymptomatic microfilaremic perso ns, who had been assumed to have infection but not disease. All patien ts with clinical manifestations of lymphatic pathology had marked abno rmalities. No correlation was found between clinical findings and actu al lymphatic function as demonstrated by lymphoscintigraphy. The initi al diagnosis of lymphatic filariasis, whether asymptomatic or symptoma tic, is based an nonimaging laboratory criteria. After diagnosis, lymp hoscintigraphy is a valuable tool for initial assessment of any lympha tic damage. Changes in strategies for therapeutic interventions in asy mptomatic microfilaremic persons, who are not usually aggressively tre ated, may be warranted.