A CASE REPORT OF LATE ONSET PRIMARY LYMPHEDEMA - FROM DIAGNOSIS TO SUCCESSFUL MANAGEMENT STRATEGIES

Abstract

We present a case report of a 46-year-old nurse with lower limb, late onset, second degree primary lymphedema diagnosed thirty years after symptoms onset. Lack of specialised lymphedema clinics, lymphedema specialist, lymphedema management guidelines and lymphedema registry are main causes for prolonged diagnosis in Croatia.

Primary lymphedema treatment was conducted through seven 45 minutes sessions three times a week. Treatment sessions consisted of limb circumference measurements, manual lymph drainage followed by Partsch compression therapy protocol and education. Instructions for physical activity were made likewise. Significant volume reduction was successful despite long primary lymphedema duration.

Changes in quality of life and physical activity were noted by self-administered questionnaires.

Compression garment specialist made measures for flat knitted stockings compression class III. that are indicated for lymphedema and have important role in the maintenance phase of limb volume.

Despite the fact that primary lymphedema is chronic condition and it has been left untreated for over thirty years by proper lymphedema therapy management and teamwork it is possible to achieve and maintain satisfying treatment results especially if you have motivated and properly educated patient.