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January 1981

Arm Lymphedema Associated With Filariasis

Author Affiliations

Nedlands, West Australia

Arch Intern Med. 1981;141(1):137. doi:10.1001/archinte.1981.00340010129026

To the Editor.  —We were interested to read the report by Guillozet in the Archives (1979;139:1057-1059) concerning a patient with upper-extremity lymphedema that was attributed to filariasis and, by implication, to infection with Wuchereria bancrofti. However, there are several aspects of the report that require clarification.It would have been far more informative to specify the country and, preferably, the exact location within that country in which the patient lived rather than to say that he had "three years' residence in a tropical African nation." The finding of "nonpitting edema limited to the left forearm and ending at the carpal tunnel" is more suggestive of loiasis than bancroftian filariasis. This conclusion is reinforced by the presence of an eosinophilia of 3,161 eosinophils per cubic millimeter, the spontaneous subcutaneous subsidence of the edema in four days, and a normal lymphangiogram. This diagnosis should have been sought by looking for microfilariae in

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