Lymphatic Malformations Discussion

This is a 2 part assignment. The 1st part is to read the material and then write the initial discussion post. The 2nd part is to write a short reply to 3 classmates posts. Once the initial post is completed I will post here 3 other classmates posts for you to write a short reply to. 

The first part of the assignment must be completed within 24 hours.

Assignment:

Malformations in the lymphatic system, called lymphangiomas, are overgrowths of the one-way lymph channels. Rarely, in infants and children, these channels grow abnormally large and cause deformity or death if the overgrowth chokes off a child’s airway or interferes with other aspects of heart and lung function. The deformity tends to grow with the child, worsening over time and is difficult to treat.

Physicians at Lucile Packard Children’s Hospital at Stanford (Links to an external site.) discovered, essentially by accident, that a common drug – sildenafil, a.k.a. Viagra – appears to shrink the overgrown vessels. They gave sildenafil to a child with a severe lymphangioma to treat another condition, pulmonary hypertension, and noticed that the lymph malformation shrank significantly. Unfortunately, the child’s underlying condition was so severe that she later died; however, two subsequent patients have done well on the medication.

“There has been no medical treatment for lymphangiomas; now all of a sudden there may be one,” said Al Lane, MD, a co-author on the NEJM letter published January 2012 and an investigator on the lymphangioma research now being conducted. The mechanism by which the drug could resolve the malformations is not known, however, there’s a possibility that sildenafil may help to open and drain the channels,” Lane said.

The drug (Viagra) has been used to treat pulmonary hypertension in children. Its typical side effects in children are nausea, headaches and cold-like symptoms such as a runny nose or fever, Lane said. Spontaneous erections are possible but are an infrequent side effect. Discuss your thoughts on studying and utilizing Viagra as a treatment for lymphangioma and its side effects in children.

Source: Lane, A. (2012, January 26). Sildenfil for Severe Lymphatic Malformations. (Links to an external site.) New England Journal of Medicine, 366. Retrieved from New England Journal of Medicine

I believe that we should definitely put manpower and money into looking into the possibility of using Sildenafil for the treatment of Lymphangiomas, especially since the only treatments currently being looked at are invasive surgery and sclerotherapy, which are not even guaranteed to completely cure the disease, often resulting in local recurrence and complications due to the rather invasive nature of the treatments. Sildenafil is already a drug that is being used today and has been for quite a while, with relatively benign side effects like headaches, dizziness, and hot flashes, which, compared to the effects of Lymphangiomas, is but a drop in the bucket. Despite this, Sildenafil should definitely be studied and have to be recertified by the FDA for its use in the treatment of Lymphangiomas and should undergo clinical trials to make sure it is safe to use on infants and kids, as the normal usage of Sildenafil is targeted for adults. With relatively small side effects in comparison to the effects of Lymphangiomas, I believe it is well worth the time, effort, and money needed to study the possibility of using Sildenafil for the treatment of this disease.

Sources:

https://clinicaltrials.gov/ct2/show/NCT02335242

As you mentioned children’s or infant usually not many are born with (congenital). “This means that the issue happened during pregnancy, when your baby was forming. When the lymphatic vessels formed, they may have become blocked and enlarged. This could cause lymphatic fluid to build up. “ And with Symptoms it depend on the size of the malformation and where it is. They can include “A soft, smooth lump or mass. Which most often on the neck. It can also be on your child’s head, mouth, tongue, eye, chest, stomach, arms, legs, or scrotum and penis.A lump or mass that gets larger quickly. This could also be because of bleeding or an infection.Swelling, pain, bleeding, and infection. Signs of infection can include redness, warmth, pain, swelling, and drainage.” And with Treatment will all depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition.

The baby’s healthcare provider may refer your baby to a specialist for treatment.And the baby may need to see an ear, nose, and throat doctor or a surgeon. So with this particular condition you have to be aware and make sure of your kids / infants are well taking care of. And get the help they need!

https://www.stanfordchildrens.org/en/topic/default?id=lymphatic-malformations-90-P02045

I believe that the usage of Sildenafil (Viagra) should be used for the treatment of lymphangiomas under observation on an experimental status until it goes through final approval by the FDA and other agencies. It is already used in the medical field for the treatment of pulmonary hypertension with relatively mild symptoms. These symptoms include nausea, headaches, and cold-like symptoms. This is a worthwhile tradeoff for pulmonary hypertension or the life-threatening risks of lymphangiomas in my opinion and I believe that most reasonable people would agree. It is worth noting that other than the usage of Sildenafil, there are no other treatment options for lymphangiomas. This is even more of a reason to utilize Sildenafil for treatment. Otherwise, the only other option is ultimately death.