Skip to main content

Clinical Disorders of Primary Malfunctioning of the Lymphatic System

  • Chapter
  • First Online:

Part of the book series: Advances in Anatomy, Embryology and Cell Biology ((ADVSANAT,volume 214))

Abstract

Primary lymphedema is defined as lymphedema caused by dysplasia of the lymph vessels. This complex group of diseases is discussed in detail from a clinical perspective. A review of the epidemiology and classification of lymphedema on the backdrop of its clinical presentation reveals weaknesses of the present classification system, which, however, is the basis for the choice of optimal patient care. Non-syndrome and syndrome types of primary lymphedema are presented in detail and related molecular findings are summarized.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   179.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  • Alders, M., Hogan, B. M., Gjini, E., Salehi, F., Al-Gazali, L., Hennekam, E. A., et al. (2009). Mutations in CCBE1 cause generalized lymph vessel dysplasia in humans. Nature Genetics, 41, 1272–1274.

    Article  PubMed  CAS  Google Scholar 

  • Alders, M., Mendola, A., Adès, L., Al Gazali, L., Bellini, C., Dallapiccola, B., et al. (2013). Evaluation of clinical manifestations in patients with severe lymphedema with and without CCBE1 mutations. Molecular Syndromology, 4(3), 107–113.

    PubMed  CAS  Google Scholar 

  • Alitalo, K. (2011). The lymphatic vasculature in disease. Nature Medicine, 17, 1371–1380.

    Article  PubMed  CAS  Google Scholar 

  • Bellini, C., Boccardo, F., Bonioli, E., & Campisi, C. (2006). Lymphodynamics in the fetus and newborn. Lymphology, 39, 110–117.

    PubMed  CAS  Google Scholar 

  • Bellini, C., Boccardo, F., Campisi, C., Villa, G., Taddei, G., Traggiai, C., et al. (2008). Lymphatic dysplasias in newborns and children: The role of lymphoscintigraphy. J Pediatric, 152, 587–589.

    Article  Google Scholar 

  • Bellini, C., Ergaz, Z., Boccardo, F., Bellini, T., Bonioli, E., & Ramenghi, L. A. (2013). Dynamics of pleural fluid effusion and chylothorax in the fetus and newborn: Role of the lymphatic system. Lymphology. in press.

    Google Scholar 

  • Bellini, C., Ergaz, Z., Radicioni, M., Forner-Cordero, I., Witte, M., Perotti, G., et al. (2012). Congenital fetal and neonatal visceral chylous effusions: Neonatal chylothorax and chylous ascites revisited. A multicenter retrospective study. Lymphology, 45, 91–102.

    PubMed  CAS  Google Scholar 

  • Belov, S. T. (1993). Anatomopathological classification of congenital vascular defects. Seminars in Vascular Surgery, 6, 219–224.

    PubMed  CAS  Google Scholar 

  • Braamskamp, M. J., Dolman, K. M., & Tabbers, M. M. (2010). Clinical practice. Protein-losing enteropathy in children. European Journal of Pediatrics, 169, 1179–1185.

    Article  PubMed  Google Scholar 

  • Brice, G., Child, A. H., Evans, A., Bell, R., Mansour, S., Burnand, K., et al. (2005). Milroy disease and the VEGFR-3 mutation phenotype. Journal of Medical Genetics, 42, 98–102.

    Article  PubMed  CAS  Google Scholar 

  • Brice, G., Mansour, S., Bell, R., Collin, J. R., Child, A. H., Brady, A. F., et al. (2002). Analysis of the phenotypic abnormalities in lymphoedema-distichiasis syndrome in 74 patients with FOXC2 mutations or linkage to 16q24. Journal of Medical Genetics, 39, 478–483.

    Article  PubMed  CAS  Google Scholar 

  • Child, A. H., Gordon, K. D., Sharpe, P., Brice, G., Ostergaard, P., Jeffery, S., et al. (2010). Lipedema: An inherited condition. American Journal of Medical Genetics Part A, 152A, 970–976.

    Article  PubMed  Google Scholar 

  • Connell, F., Brice, G., Mansour, S., & Mortimer, P. (2009). Presentation of childhood lymphoedema. Journal of Lymphoedema, 4, 65–72.

    Google Scholar 

  • Connell, F., Kalidas, K., Ostergaard, P., Brice, G., Homfray, T., Roberts, L., et al. (2010). Linkage and sequence analysis indicate that CCBE1 is mutated in recessively inherited generalised lymphatic dysplasia. Human Genetics, 127, 231–241.

    Article  PubMed  Google Scholar 

  • Daniel-Spiegel, E., Ghalamkarpour, A., Spiegel, R., Weiner, E., Vikkula, M., Shalev, E., et al. (2005). Hydrops fetalis: An unusual prenatal presentation of hereditary congenital lymphedema. Prenatal Diagnosis, 25, 1015–1018.

    Article  PubMed  Google Scholar 

  • Dubin, P. J., King, I. N., & Gallagher, P. G. (2000). Congenital chylothorax. Current Opinion in Pediatrics, 12, 505–509.

    Article  PubMed  CAS  Google Scholar 

  • Enjolras, O., & Mulliken, J. B. (1997). Vascular tumors and vascular malformations (new issues). Advances in Dermatology, 13, 375–423.

    PubMed  CAS  Google Scholar 

  • Fang, J., Dagenais, S. L., Erickson, R. P., Arlt, M. F., Glynn, M. W., Gorski, J. L., et al. (2000). Mutations in FOXC2 (MFH-1), a forkhead family transcription factor, are responsible for the hereditary lymphedema-distichiasis syndrome. American Journal of Human Genetics, 67, 1382–1388.

    Article  PubMed  CAS  Google Scholar 

  • Ferrell, R. E., Levinson, K. L., Esman, J. H., Kimak, M. A., Lawrence, E. C., Barmada, M. M., et al. (1998). Hereditary lymphoedema: Evidence for linkage and genetic heterogeneity. Human Molecular Genetics, 7, 2073–2078.

    Article  PubMed  CAS  Google Scholar 

  • Fox, G. F., Challis, D., O’Brien, K. K., Kelly, E. N., & Ryan, G. (1998). Congenital chylothorax in siblings. Acta Paediatrica, 87, 1010–1012.

    Article  PubMed  CAS  Google Scholar 

  • Gordon, K., Schulte, D., Brice, G., Simpson, M. A., Roukens, M. G., van Impel, A., et al. (2013). Mutation in vascular endothelial growth factor-C, a ligand for vascular endothelial growth factor receptor-3, is associated with autosomal dominant milroy-like primary lymphedema. Circulation Research, 112(6), 956–960.

    Article  PubMed  CAS  Google Scholar 

  • Hennekam, R. C., Biesecker, L. G., Allanson, J. E., Hall, J. G., Opitz, J. M., Temple, I. K., et al. (2013). Elements of morphology: General terms for congenital anomalies. American Journal of Medical Genetics. [epub ahead of print].

    Google Scholar 

  • Hennekam, R. C. M., Geerdink, R. A., Hamel, B. C., Hennekam, F. A., Kraus, P., Rammeloo, J. A., et al. (1989). Autosomal recessive intestinal lymphangiectasia and lymphoedema, with facial anomalies and mental retardation. American Journal of Medical Genetics, 34, 593–600.

    Article  PubMed  CAS  Google Scholar 

  • Irrthum, A., Devriendt, K., Chitayat, D., Matthijs, G., Glade, C., Steijlen, P. M., et al. (2003). Mutations in the transcription factor gene SOX18 underlie recessive and dominant forms of hypotrichosis-lymphedema-telangiectasia. American Journal of Human Genetics, 72, 1470–1478.

    Article  PubMed  CAS  Google Scholar 

  • Keeley, V. (2006). The use of lymphoscintigraphy in the management of chronic oedema. Journal of Lymphoedema, 1, 42–57.

    Google Scholar 

  • Lee, B. B., Kim, Y. W., Seo, J. M., Hwang, J. H., Do, Y. S., Kim, D. I., et al. (2005). Current concepts in lymphatic malformation. Vascular and Endovascular Surgery, 39, 67–81.

    Article  PubMed  CAS  Google Scholar 

  • Martinez-Corral, I., & Makinen, T. (2013). Regulation of lymphatic vascular morphogenesis: Implications for pathological (tumor) lymphangiogenesis. Experimental Cell Research, S0014–4827(13), 00034–00037. doi:10.1016/j.yexcr.2013.01.016 [Epub ahead of print].

    Google Scholar 

  • Moffatt, C. J., Franks, P. J., Doherty, D. C., Williams, A. F., Badger, C., Jeffs, E., et al. (2003). Lymphoedema: An underestimated health problem. Quarterly Journal of Medicine, 96, 731–738.

    Article  CAS  Google Scholar 

  • Mortimer, P. S. (1995). Managing lymphoedema. Clinical and Experimental Dermatology, 20, 98–106.

    Article  PubMed  CAS  Google Scholar 

  • Mulliken, J. B., & Glowacki, X. X. (1982). Classification of pediatric vascular lesions. Journal of Plastic and Reconstructive Surgery, 69, 412–422.

    Article  CAS  Google Scholar 

  • Rauen, K. A. (2013). The RASopathies. Annual Review Genomics Human Genetics, 14, 355–369.

    Google Scholar 

  • Rezaie, T., Ghoroghchian, R., Bell, R., Brice, G., Hasan, A., Burnand, K., et al. (2008). Primary non-syndromic lymphoedema (Meige disease) is not caused by mutations in FOXC2. European Journal of Human Genetics, 16, 300–304.

    Article  PubMed  CAS  Google Scholar 

  • Rockson, S. G., & Rivera, K. K. (2008). Estimating the population burden of lymphoedema. Annals of the New York Academy of Sciences, 1131, 147–154.

    Article  PubMed  Google Scholar 

  • Smeltzer, D. M., Stickler, G. B., & Schirger, A. (1985). Primary lymphedema in children and adolescents: A follow-up study and review. Pediatrics, 76, 206–218.

    PubMed  CAS  Google Scholar 

  • Straats, B. A., Ellefson, R. D., Budahn, L. L., Dines, D. E., Prakash, U. B., & Offord, K. (1980). The lipoprotein profile of chylous and nonchylous pleural effusions. Mayo Clinic Proceedings, 11, 700–704.

    Google Scholar 

  • Sutkowska, E., Gil, J., Stembalska, A., Hill-Bator, A., & Szuba, A. (2012). Novel mutation in the FOXC2 gene in three generations of a family with lymphoedema-distichiasis syndrome. Gene, 498, 96–99.

    Article  PubMed  CAS  Google Scholar 

  • Tammela, T., & Alitalo, K. (2010). Lymphangiogenesis: Molecular mechanisms and future promise. Cell, 140, 460–476.

    Article  PubMed  CAS  Google Scholar 

  • Tiwari, A., Myint, F., & Hamilton, G. (2006). Management of lower limb lymphoedema in the United Kingdom. European Journal of Vascular and Endovascular Surgery, 31, 311–315.

    Article  PubMed  CAS  Google Scholar 

  • Van Balkom, I. D. C., Alders, M., Allanson, J., Bellini, C., Frank, U., De Jong, G., et al. (2002). Lymphoedema-lymphangiectasia-mental retardation (Hennekam) syndrome: A review. American Journal of Medical Genetics, 112, 412–421.

    Article  PubMed  Google Scholar 

  • Vignes, S., & Bellanger, J. (2008). Primary intestinal lymphangiectasia (Waldmann’s disease). Orphanet Journal of Rare Diseases, 3, 5.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Raoul CM Hennekam .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer-Verlag Wien

About this chapter

Cite this chapter

Bellini, C., Hennekam, R.C. (2014). Clinical Disorders of Primary Malfunctioning of the Lymphatic System. In: Kiefer, F., Schulte-Merker, S. (eds) Developmental Aspects of the Lymphatic Vascular System. Advances in Anatomy, Embryology and Cell Biology, vol 214. Springer, Vienna. https://doi.org/10.1007/978-3-7091-1646-3_14

Download citation

  • DOI: https://doi.org/10.1007/978-3-7091-1646-3_14

  • Published:

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-7091-1645-6

  • Online ISBN: 978-3-7091-1646-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics