Pathogenesis of filarial hydrocele: risk associated with intrascrotal nodules caused by death of adult Wuchereria bancrofti

Pathogenesis of filarial hydrocele: risk associated with intrascrotal nodules caused by death of adult Wuchereria bancrofti

Author Noroes, J. Google Scholar
Addiss, D. Google Scholar
Cedenho, A. Google Scholar
Figueredo-Silva, J. Google Scholar
Lima, G. Google Scholar
Dreyer, G. Google Scholar
Institution Universidade Federal de Pernambuco (UFPE)
Ctr Dis Control
Universidade Federal de São Paulo (UNIFESP)
Lab Imunopatol Keizo Asami
Fiocruz MS
Abstract Although testicular hydrocele is the most common clinical manifestation of bancroftian filariasis, its pathogenesis is poorly understood, as is its relationship to inflammatory scrotal nodules following death of adult Wuchereria bancrofti. Between 1994 and 1998, we prospectively determined the incidence and clinical evolution of nodule-associated acute hydrocele in men attending 2 outpatient clinics in Recife, Brazil who were infected with W. bancrofti, had living adult worms detectable by ultrasound in the intrascrotal lymphatic vessels, and were scheduled for treatment with 6 mg/kg diethylcarbamazine (DEC). A total of 132 men developed 173 scrotal nodules 1-7 (mean 4.2) d after DEC treatment and another 47 developed 58 spontaneous nodules before they received DEC treatment. These 179 men with a single 'nodule event' (simultaneous development of greater than or equal to 1 scrotal nodules) were followed-up by serial physical and ultrasound examinations for 18 months. Overall, 40 (22.3%) men developed acute hydrocele, 3 of whom underwent biopsy and hydrocele repair. of the remaining 37 men, 9 (24.3%) developed chronic hydrocele and 28 had acute hydrocele resolution within 14-210 (mean 60.9) d. Rate of chronic hydrocele was similar for men who received DEC and those with spontaneous nodules. Seventeen (42.5%) men with hydrocele had multiple scrotal nodules, compared with 28 (20.1%) men who did not develop hydrocele (P= 0.007). of 134 men with single nodules, superior paratesticular nodules were found in 56.5% and 29.7% of those with and without hydrocele, respectively (P= 0.02). Acute hydrocele occurs frequently following death of adult W. bancrofti and single episodes of scrotal nodule formation. Chronic hydrocele may develop following 5.1% of these episodes.
Keywords bancroftian filariasis
Wuchereria bancrofti
acute hydrocele
chronic hydrocele
diethylcarbamazine
histopathology
Brazil
Language English
Date 2003-09-01
Published in Transactions of the Royal Society of Tropical Medicine and Hygiene. London: Royal Soc Tropical Medicine, v. 97, n. 5, p. 561-566, 2003.
ISSN 0035-9203 (Sherpa/Romeo, impact factor)
Publisher Royal Soc Tropical Medicine
Extent 561-566
Origin http://dx.doi.org/10.1016/S0035-9203(03)80029-9
Access rights Closed access
Type Article
Web of Science ID WOS:000223176500021
URI http://repositorio.unifesp.br/handle/11600/27389

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