Chronic hereditary lymphoedema

Last revised by Sonam Vadera on 21 Jul 2022

Chronic hereditary lymphoedema (also known as Milroy disease) is a condition characterised by lower limb lymphoedema. Patients typically present with pedal oedema at or before birth or soon after. Occasionally, it develops later in life.

The commonest presentation is bilateral asymmetric lymphoedema in the lower limbs. However, all distal extremities can be affected. The oedema tends to be progressive 4.

Complications can include:

  • pleural effusion
  • recurrent septic arthritis 
  • skin changes
  • infections of the toes
  • intestinal lymphangiectasia

Mutations in the FLT4 gene are thought to be present in some cases. It is usually inherited in an autosomal dominant pattern.

Management is usually conservative, and involves limb elevation, skin care, compression and manual lymphatic drainage. Surgical bypass and debulking procedures are considered a last resort 4.

It is thought to have first been described by Letessier in 1865 1.

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