scholarly journals Predicting the risk of neurological complications in the erythemal form of ixodes Lyme disease

2016 ◽  
Vol 21 (6) ◽  
pp. 341-346
Author(s):  
D. Yu Moshkova ◽  
Marina G. Avdeeva

The aim. The prediction of risk degrees of neurological complications in adult patients with erythemal form of borreliosis for the timely appointment of causal and pathogenetic therapy. Materials and methods. We observed 46 patients hospitalized in infectious hospital in Krasnodar in 2013-2014, with a diagnosis of Ixodes tick-borne Lyme disease, erythemal form, acute course was observed in 41 (89.1%) person, subacute - in 2 (4.4%), chronic - 3 (6.5%). In the course of the disease there was studied the level of pro-inflammatory cytokine IFN-y. Results. The average age of patients was 41.1 ± 1.83 years, among them women (63%) dominated. In 31% of patients there were observed symptoms of the damage of the nervous system. From the first week of the disease there was noted a significant increase in the level of IFN-y, which persisted both in the subacute and chronic course of the disease. The average level of IFN-y in patients with signs of the damage of the central and peripheral nervous system accounted for 64.8±14.19 pg/ml being ignificantly higher (P 20.0 pg/ml symptoms of the damage of the nervous system were recorded in 50% of cases. The degrees of neurological complications risk in patients with tick-borne Lyme disease are determined: the IFN-y level of 20.0-34.99 pg/ml predicted the risk of 1 degree (12.5%), level of 35,0-79,99 pg/ml - the risk of 2 degree (45%), the level higher than 80.0pg/ml - the risk of 3 degree (100%). Conclusion. The use of the determination of the IFN-y level can increase the accuracy and provide the timeliness of diagnosis of neurological complications in Lyme borreliosis cases, that is important for the prognosis and treatment of the disease.

2016 ◽  
Vol 21 (2) ◽  
pp. 86-92
Author(s):  
D. Yu Moshkova ◽  
Marina G. Avdeeva

The cytokine status was studied in 46patients hospitalized in Specialized Clinical Infectious Diseases Hospital in 2013-2014. Acute course of the infection of Ixodes tick borreliosis (ITB) was observed in the 41 (89%) case, subacute and chronic - in 5 (11%), in the dynamics of the disease there was studied the level of proinflammatory (IFN-y, IL-1β, IL-2) and anti-inflammatory ( IL-4, IL-10) cytokines. The average age of diseased patients in the acute course of the erythemalform of ITB amounted to 41,1 ± 1,83 years, men accouted for 37%, women - 63%. In 31.1% of the patients there were observed symptoms of the involvement of the peripheral nervous system PNC, in 51.1% - changes in the cardiovascular system. For the acute course of the erythemal form of ITB there is typical the significant increase ofIL-1β, IFN-y and IL-4 level, while in maintaining of normal levels of IL-2 and IL-10 low values in the majority of patients. In subacute and chronic course of Ixodes borreliosis there is persisted the elevated level of IL-1β, IFN-y, normal values of IL2 and low values of IL-10, while the level of IL-4 is also lowered. The increase of the IL-2 level in the acute course of the erythemal form of Ixodes borreliosis is associated with fever and involvement of the cardiovascular system. In the process of causal treatment with ceftriaxone (examination on the 5th and 12th day of the treatment) there was a significant decrease in the level of IL-2 (p


Author(s):  
Andrew Graham ◽  
Clare Galton

Rheumatological conditions may be complicated by a variety of both central and peripheral nervous system disorders. Common complications such as entrapment neuropathies are familiar to rheumatologists but accurate diagnosis of less common neurological disorders may be challenging; careful clinical reasoning is essential, supplemented where necessary by imaging, neurophysiology, and other special investigations including cerebrospinal fluid examination. Complications vary according to the nature of the background condition. In rheumatoid arthritis, neurological involvement is typically related to the mechanical consequences of advancing disease; most commonly, entrapment neuropathies such as carpal tunnel syndrome and cervical myelopathy due to atlantoaxial subluxation. By contrast, neurological involvement in systemic lupus erythematosus (SLE) tends to occur earlier in the disease course, with a much wider range of manifestations. The management of stroke or seizures in SLE is not necessarily any different from that in the general population, unless complicated by the antiphospholipid syndrome. However, less common neurological syndromes may demand more specific investigation and treatment. For example, longitudinally extensive transverse myelitis and recurrent optic neuritis (neuromyelitis optica, or Devic’s disease) is frequently associated with antibodies to aquaporin-4, and is highly likely to relapse unless treated vigorously with humoral immunosuppression. Nervous system involvement in vasculitis is common. Finally, not all neurological disorder in rheumatological disease is necessarily due to the underlying condition; neurological complications of disease-modifying therapy are increasingly recognized, in particular central and peripheral nervous system demyelination associated with TNF-α‎‎ inhibitors.


Author(s):  
Aaron E. Miller ◽  
Teresa M. DeAngelis

Rheumatoid arthritis (RA) is a systemic inflammatory disease that is characterized principally by a polyarthritis, but can result in several neurologic complications involving both the central and peripheral nervous system. In addition, several immunotherapies used to treat RA have been associated with neurological complications. In this chapter, we review the characteristic neurological sequelae of RA as well as the possible neurological consequences of its therapeutic regimens.


2019 ◽  
Vol 59 (5) ◽  
pp. 567-576 ◽  
Author(s):  
Stefanie Schreiber ◽  
Frank Schreiber ◽  
Cornelia Garz ◽  
Grazyna Debska‐Vielhaber ◽  
Anne Assmann ◽  
...  

Author(s):  
L. P. Melnyk ◽  
L. A. Hryshchuk ◽  
M. Koziol–Montewka ◽  
P. S. Tabas ◽  
R. O. Klos

Background. Lyme disease has many clinical features similar tothose in sarcoidosis and tuberculosis. Epidemiological data in the world, in particular in Ukraine, proves the increase in Lyme borreliosis incidence. Ternopil region is endemic with Lyme borreliosis.Objective. The research was aimed to investigate the prevalence of infection with Borrelia burgdorferi and epidemiology features of borreliosis among the patients of Ternopil Regional TB Dispensary.Methods. In total, 29 patients were admitted to Departments of Differential Diagnostic, TB Therapy and TB Surgery of Ternopil Regional TB Dispensary in October 2016-January 2017. All the surveyed answered the questions of an integrated international questionnaire, where they noted the area and a number of tick bites, described the removal method, noted the survey for borreliosis pathogen and complaints after tick bites.Results. It was established that 5 respondents had a history of tick bites episodes, but only in one case the patient was examined of borreliosis. Tick bites were noticed in 3 patients with sarcoidosis and 1 with tuberculosis (TB) and exudative pleurisy, respectively.Conclusions. The absence of appeals for medical care, lack of sufficient information on Lyme borreliosis and disuse of preventive measures for tick bites by the interviewed patients of Ternopil regional TB dispensary departments proves the need of improvement of health education on Lyme borreliosis (LB) among this category of population. 24 (82.7%) of 29 respondents did not remember the tick bite. The symptoms of (LB) are similar to those in sarcoidosis and tuberculosis (pleural lesions, heart, joints, nervous system, skin), and the presence of tick bites gives the reasons to examine these patients of Borrelia burgdorferi senso lato.


Author(s):  
Andrew Graham ◽  
Clare Galton

Rheumatological conditions may be complicated by a variety of both central and peripheral nervous system disorder. Common complications such as entrapment neuropathies are familiar to rheumatologists but accurate diagnosis of less common neurological disorders may be challenging; careful clinical reasoning is essential, supplemented where necessary by imaging, neurophysiology, and other special investigations including cerebrospinal fluid examination. Complications vary according to the nature of background condition. In rheumatoid arthritis, neurological involvement is typically related to the mechanical consequences of advancing disease; the commonest complications are carpal tunnel syndrome and cervical myelopathy due to atlantoaxial subluxation. By contrast, neurological involvement in systemic lupus erythematosus (SLE) tends to occur earlier in the disease course, with a much wider range of manifestations. The management of stroke or seizures in SLE is not necessarily any different from that in the general population, unless complicated by the antiphospholipid syndrome. However, less common neurological syndromes may demand more specific investigation and treatment. For example, longitudinally extensive transverse myelitis and recurrent optic neuritis (neuromyelitis optica, or Devic's disease) is frequently associated with antibodies to aquaporin-4, and is highly likely to relapse unless treated vigorously with humoral immunosuppression. Nervous system involvement in vasculitis is common. Finally, not all neurological disorder in rheumatological disease is necessarily due to the underlying condition; neurological complications of disease-modifying therapy are increasingly recognized, in particular central and peripheral nervous system demyelination associated with TNF-α‎ inhibitors.


2020 ◽  
Vol 54 (5) ◽  
pp. 364-369 ◽  
Author(s):  
Ettore Beghi ◽  
Valery Feigin ◽  
Valeria Caso ◽  
Paola Santalucia ◽  
Giancarlo Logroscino

The present outbreak caused by SARS-CoV-2, an influenza virus with neurotropic potential, presents with neurological manifestations in a large proportion of the affected individuals. Disorders of the central and peripheral nervous system are all present, while stroke, ataxia, seizures, and depressed level of consciousness are more common in severely affected patients. People with these severe complications are most likely elderly with medical comorbidities, especially hypertension and other vascular risk factors. However, postinfectious complications are also expected. Neurological disorders as sequelae of influenza viruses have been repeatedly documented in the past and include symptoms, signs, and diseases occurring during the acute phase and, not rarely, during follow-up. Postinfectious neurological complications are the result of the activation of immune mechanisms and can explain the insurgence of immune-mediated diseases, including the Guillain-Barré syndrome and other diseases of the central and peripheral nervous system that in the past occurred as complications of viral infections and occasionally with vaccines. For these reasons, the present outbreak calls for the introduction of surveillance systems to monitor changes in the frequency of several immune-mediated neurological diseases. These changes will determine a reorganization of the measures apt to describe the interaction between the virus, the environment, and the host in areas of different dimensions, from local communities to regions with several millions of inhabitants. The public health system, mainly primary care, needs to be strengthened to ensure that research and development efforts are directed toward right needs and directions. To cope with the present pandemic, better collaboration is required between international organizations along with more research funding, and tools in order to detect, treat, and prevent future epidemics.


2019 ◽  
pp. 321-328 ◽  
Author(s):  
Katarzyna Krawczuk ◽  
Piotr Czupryna ◽  
Sławomir Pancewicz ◽  
Elżbieta Ołdak ◽  
Monika Król ◽  
...  

Neuroborreliosis is one of the manifestations of Lyme disease involving central and peripheral nervous system. It is caused by infection with Borrelia burgdorferi spirochete which is transmitted by tick bites. Neuroborreliosis can affect both adults and children. The clinical course in children is often different than in adults. The article discusses the most common clinical symptoms, complications, diagnostics and treatment of neuroborreliosis in children.


2020 ◽  
Vol 21 (4) ◽  
pp. 140-144
Author(s):  
M. A. Ahmet’yanov ◽  
◽  
O. A. Kicherova ◽  
L. I. Reikhert ◽  
M. V. Deeva ◽  
...  

The pandemic of the new SARS-CoV2, that started at the beginning of 2020, caused a catastrophic increase in morbidity and mortality in early 2020 and posed a number of challenges for healthcare system. Primarily, this concerns the study of the effect on different organs and systems, that new virus can exhibit. This knowledge further can serve as a key to the development of effective methods for the prevention and treatment of COVID-19 associated pathological conditions. The objectives of this review include the analysis of neurological complications caused by the new coronavirus infection and the determination of the possible mechanisms of the virus’s effect on the human nervous system.


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