Treatment of Primary Lymphedema Following Lessons from Endothelin-Driven Retinal Edema: A Case Report

We report a case of late onset primary lymphedema (lymphedema tarda) where edema is managed with high levels of B vitamins. This is the first successful treatment of lymphedema where a patient's function is fully restored without the limitation of compressive garments. This restored mobility is of significant benefit to the patient, as it allowed them to reengage in the activities of daily life. Similar to the edema seen in retinal veins in those with elevated endothelin levels, we speculate that the edema in primary lymphedema is related to diseased lymphatic vascular health. In our case, following 12 months of high dose B vitamins. similar results were seen as in retinal cases, with elimination of edema and restoration of an active quality of life for the patient, an outcome that was sustained a year later. Given the proven absence of toxicity or side effects, we suggest employment of such vitamin therapy as the standard tool in management of primary lymphedema. PEER REVIEWED ARTICLE Peer reviewers: Dr Alexandru Grigorean, Universitätsspital Zurich, Klinik für Angiologie One anonymous peer reviewer Received on July 28, 2024; accepted after peer review on September 19, 2024; published on October 30, 2024.