There is not much evidence of how lymphedema causes blood clots, but there are few articles about it. This is an area more research can be done to find the exact pathophysiology behind the formation of lymphedema blood clots.
You may have read there are four stages in lymphoma:
Lymphedema Stage 0 – Subclinical or Latent Stage
Most lymphedema patients are asymptomatic. The swelling is not evident despite impaired lymphatic transport. The individual may complain of weight in the limb, itching, tightness when the clothing is worn. On examination pitting edema is not present.
Stage 1 Lymphedema – Light Stage
There is a gathering of protein-rich lymphatic fluid that relaxes with limb elevation at this stage of lymphedema. The edema is well regarded in the second half of the day. On examination, stinging edema is present. The skin is soft without dermal fibrosis. This is also called the reversible stage of lymphedema, as edema may disappear with limb elevation / compression.
Lymphedema Stage 2 – Moderate Stage
There is a collection of protein-rich lymphatic fluid that does not disappear with limb elevation. There is early derma fibrosis at this stage of lymphedema. Sting edema may or may not be present because fibrosis has developed. This is also called spontaneously irreversible as it does not reverse with compression. Dermal fibrosis may improve and reverse with prolonged treatment.
Lymphedema Stage 3 – Severe Stage
Lymphedema Stage 3 is also called lymphostatic elephantiasis. On examination, there is coarse non-corrosive edema. Tropical skin disorders such as fat deposits, acanthosis, papillomatosis and hyperkeratosis develop. There may be lobes that can be a hygiene problem. Skin creases are more prone to yeast infections, secondary infections and skin lesions.
What is blood clot formation?
The formation of blood clots is known as deep vein thrombosis (DVT). In DVT, blood clots form in the deep veins of the body. Most deep vein clots occur in the leg or thigh. This is a serious condition as these blood clots or parts of these blood clots can dislodge and go to your lungs and block a blood vessel in your lung. This is called pulmonary embolism and can cause death if not treated immediately.
- DVT is a serious life-threatening complication of long-term stage 2 or 3 lymphedema with extensive fibrosis. There are many risk factors for DVT, but the main risk factors for DVT in lymphedema patients are:
- Fibrosis and its effects on vascular system and blood flow
- Recurrent infections such as cellulitis, lymphangitis
- If you have additional risk factors with above mentioned risk factors for DVT then the chance of having DVT is high. Therefore, you need to be very careful and vigilant about this. The symptoms of DVT are sudden onset pain, swollen leg or thigh with redness and increased temperature in the affected area. You will find it difficult to walk or move your leg, it will be painful. If you have these symptoms, you will need to go to the hospital for investigation and treatment.
Prevention of Deep Vein Thrombosis in Patients with Lymphedema
Decongestive Lymphatic Therapy (DLT) can decrease and control lymphedema, which will help to prevent dermal fibrosis.
Proper skin care to prevent cuts, blisters, burns and sores will prevent cellulite and lymphangitis.
Another point to remember is that DVT can cause chronic venous insufficiency, damaging the valves in the veins and blocking the veins. Chronic venous insufficiency can lead to lymphedema. Thus, lymphedema can cause DVT and DVT can also cause lymphedema.
As formações de coágulos nas veias profundas são conhecidas como trombose venosa profunda e ocorrem comumente nas veias profundas da perna e coxa. Esta é uma condição potencialmente fatal, uma vez que estes coágulos sanguíneos podem se desalojar, viajar para os pulmões, bloquear os vasos sanguíneos do pulmão e causar embolia pulmonar e morte. Linfato de fase 2 ou 3 de longa duração com fibrose dérmica extensa e infecções recorrentes como celulite e linfangite podem ser fatores de risco para o desenvolvimento de TVP em pacientes com linfedema. Outro ponto a lembrar é que a TVP pode causar insuficiência venosa crônica que pode levar ao linfedema.