Can Lymphedema Cause Blood Clots?
There is not much evidence on how lymphedema causes blood clots, but there are few articles about this. This is one area more research can be done in order to find the exact pathophysiology behind blood clots formation with lymphedema
You might have read, there are four stages in lymphoma:
Stage 0 Lymphedema – Subclinical or Latent Stage
Most lymphedema patients are asymptomatic. The swelling is not evident despite the impaired lymph transport. The individual may complain heaviness in the limb, itching, tightness when clothes are worn. On examination pitting edema is not present.
Stage 1 Lymphedema – Mild Stage
There is gathering of protein-rich lymph fluid which relaxes with limb elevation in this stage of lymphedema. Edema is seen well towards the latter half of the day. On examination pitting edema is present. Skin is soft, no dermal fibrosis. This is also called reversible lymphedema stage as the edema can go away with limb elevation / compression.
Stage 2 Lymphedema – Moderate Stage
There is gathering of protein-rich lymph fluid that does not go away with limb elevation. There is early derma fibrosis in this stage of lymphedema. Pitting edema may or may not present because fibrosis has developed. This is also called spontaneously irreversible as since it does not reverse with compression. Dermal fibrosis can go improve & reverse with prolonged treatment.
Stage 3 Lymphedema – Severe Stage
Lymphedema Stage 3 is also called lymphostatic elephantiasis. On examination there is gross non-pitting edema. Tropical skin changes such as fat deposits, acanthosis, papillomatosis & hyperkeratosis develop. There may be lobules which can be a hygienic problem. Skin creases are more prone to get fungal infections, secondary infections & skin breakdown.
What Is Blood Clot Formation?
Blood clot formation is known as deep vein thrombosis (DVT). In DVT blood clots form in deep veins in 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 & goes to the lungs & block a blood vessel in your lung. This is called pulmonary embolism & it can cause death if not treated immediately.
- DVT is a serious life threatening complication of long standing 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 & its effects on the vascular system & blood flow
- Recurrent infections such as cellulitis, lymphangitis
- If you have additional risk factors with above mentioned risk factors for DVT then you chance of getting DVT is high. Therefore, you need to be really careful & vigilant about it. Symptoms of DVT are sudden onset pain, swelling in the leg or thigh with redness & increase temperature in the affected area. You will find it difficult to walk or move your leg, it will be painful. If you get these symptoms you need to get to a hospital for investigations & treatment.
Prevention of Deep Vein Thrombosis In Lymphedema Patients
Decongestive lymphatic therapy (DLT) can decrease & control lymphedema, which will help prevent dermal fibrosis.
Proper skin care to prevent cuts, blisters, burns & wound will prevent cellulitis & lymphangitis
Another point to remember is DVT can cause chronic venous insufficiency by damaging the valves in the veins & by blocking the veins. Chronic venous insufficiency can lead to lymphedema. So, lymphedema can cause DVT & DVT also can cause lymphedema.
Blood clot formations in deep veins are known as deep vein thrombosis & it commonly occurs in the deep veins in the leg & thigh. This is a life threatening condition as these blood clots can dislodge, travel to the lungs, it can block lung blood vessels & cause pulmonary embolism & death. Long standing stage 2 or 3 lymphedema with extensive dermal fibrosis & recurrent infections like cellulitis & lymphangitis can be risk factors for the development of DVT in lymphedema patients. Another point to remember is DVT can cause chronic venous insufficiency which can lead to lymphedema.