Causes of Lymphedema

Causes of lymphedema can be classified as either primary (no apparent reason) or secondary (another disease like cancer or infection causing it).

Primary lymphedema

- May be inherited. The pattern of inheritance is unknown. Not everyone in the family develops the condition

- Affects women more than men. Most women will notice that one leg is swollen after puberty. The swelling is progressive and affects the entire leg

- Congenital (Milroy's) begins in infancy. This inherited disorder that begins in infancy is due to abnormal lymph nodes which have no connection to the lymphatics from the leg. The fluid from the leg has no where to go and starts to collect in the tissues

- Meige disease (lymphedema praecox) causes lymphedema in childhood or around puberty. This inherited disorder is associated with lymphatics which have no valves. Because of the absence of valves, the fluid starts to pool and collect in the tissues. In addition, lymphatics have very thin walls and no muscle to actively push the fluid towards the heart. Over time, the tissues start to swell up with fluid.

- In some individuals, the lymphedema occurs later in life. This is known as lymphedema tarda or late onset lymphedema. The swelling of the leg is usually seen after the 3rd decade of life.

Secondary lymphedema

Any condition that damages the lymph nodes or lymph vessels can cause secondary lymphedema. Causes include:

- Surgery can sometimes be cause of lymphedema. The classic surgery which can do this is breast surgery. Anytime surgery is done where there are lots of lymph nodes, damage to the lymphatic vessels can occur. Another common area of lymphatic obstruction after surgery is in the groin

- Radiation therapy can often block the lymphatic vessels. Radiation is usually administered to individuals with cancer and can decrease lymphatic flow.

- Cancer. Many malignancies have the ability to block lymphatic vessel and cause swelling.



- Infection. Uncontrolled infection can plug up lymphatics. This is quite common with parasitic infections. Parasites are a common cause of lymphatic disorders in Africa and Asia.

- Trauma: Occasionally injury to the lymphatics may occur from trauma and lead to development of lymphedema