The following is from a recent paper "New developments in clinical aspects
of lymphatic disease" by Peter S. Mortimer and Stanley G. Rockson, The Journal of Clinical Investigation, Volume 124 Number 3 March 2014
"The range of diseases associated with lymphatic dysfunction
causing disturbed immunity is likely to be extensive. An example is
inflammatory bowel disease, particularly Crohn’s disease (CD). CD
is a chronic relapsing inflammatory disease of the gastrointestinal
tract. Abnormalities in lymphatic drainage have been noted in the
original descriptions of CD but essentially ignored since the original
publication (34). There is increasing evidence that affected patients
share a common phenotype, namely impaired immune responses to
bacterial infection. Genetic and genomic studies point to immune
deficiency, rather than autoimmunity, as the functional lesion in
CD. It is postulated that the dysregulated macrophage response
to bacteria is central to the pathogenesis of CD (35). Given the
importance of the lymphatic system to innate immunity and macrophage
function, it is not difficult to hypothesize a role for lymphatic
dysfunction in CD. This hypothesis is clinically supported
by the development of genital lymphedema caused by granulomatous
inflammation infiltrating the skin (and dermal lymphatics) in
the anogenital region (anogenital granulomatosis) (36). Recurrent
attacks of inflammation resembling cellulitis occur, and up to one
third of patients affected are found to have gastrointestinal CD."
