Lähettäjä: Soijuv Lähetetty: 12.11.2004 15:54
Miehellä oli borrelioosista + babesioosista johtuva monihermosairaus (polyneuropatia). Hän sai hoidoksi suonensisäisesti immunoglobuliinia ja parani:
Abstract: Return of muscle strength and function after use of intravenous immunoglobulin for Lyme disease-associated acute demyelinating polyneuropathy
http://www.chronicfatiguesyndromesuppor ... aditional/
09-26-2003
Arch Phys Med Rehabil. 2003 Sep;84(9):E34-E35. Cynthia Majerske, MD (University of Pittsburgh, Pittsburgh, PA); Brad Dicianno, MD; Gargi Raval, MD; Ross D. Zafonte, DO; Sasa Zivkovic, MD, e-mail: zafonterd@msx.upmc.edu.
SETTING: Tertiary care hospital acute rehabilitation unit.
Patient: A 58-year-old man with babesiosis and Lyme disease.
Case Description: The patient, who had a history of splenectomy, was admitted with diffuse myalgias, fevers, and chills. He had a history of foreign and domestic travel 6 weeks prior. He was diagnosed with babesiosis.
The patient's muscle strength on admission was 5/5 throughout, but declined during his acute care stay. The patient was transferred to the acute rehabilitation floor, where he demonstrated noted weakness primarily in the lower extremities.
Through his first week of rehabilitation, he became significantly weaker in hip flexors and knee extensors (to 2+/5) as well as developed proximal upper-extremity weakness (to 3+/5) for shoulder flexion. An electromyogram (EMG) on day 14 showed primary demyelinating sensorimotor polyneuropathy. Sural nerve biopsy was unremarkable. Western blot for Lyme disease returned positive. He was started on intravenous ceftriaxone, yet deterioration of muscle strength and function was noted.
An EMG on day 30 showed continued evidence of demyelinating polyneuropathy with significantly prolonged F-wave latencies in the upper extremities and moderate worsening in conduction velocities in 3 of 4 nerves. He was started on intravenous immunoglobulin (IVIG) on day 33 and received a total of 5 doses over 5 days.
Assessment/Results: Patient was discharged on day 38 with improving muscle strength and he was able to ambulate 150ft using a wheeled walker with supervision. At follow-up 8 weeks later, muscle strength had fully returned.
Discussion: This case illustrates that Lyme disease-associated demyelinating polyneuropathy may be treated with IVIG. The potential use of IVIG in this population is based on its efficacy in those with acute demyelinating neuropathy of alternative etiologies.
Conclusion: IV IG can be considered as a treatment option for demyelinating polyneuropathy associated with Lyme disease.
PMID: 13680780 [PubMed - as supplied by publisher]
IMMUNOGLOBULIINI BORRELIOOSIN HOIDOSSA
Valvojat: Jatta1001, Borrelioosiyhdistys, Bb
Lähettäjä: Soijuv Lähetetty: 19.11.2004 13:19
Toisenlainen näkökulma Th1/Th2 asiaan ihon T-solulymfooman kautta. Borrelioosin tavoin myös siinä tavataan matalia magnesiumpitoisuuksia. Henkilöt joilla on alhainen IgG-arvo sairastuvat helpommin. Immunoglobuliinihoito (IV IgG) näyttäisi auttavan:
Current treatment of Cutaneous T-Cell Lymphoma
Madeleine Duvic MD
Dermatology Online Journal 7(1): 3
University of Texas, MD Anderson Cancer Center
It is now appreciated that as patients progress from Stage I to Stage III (erythrodermic) or IV (nodal effacement) there is a shift in the immune response from the Th1 response (gamma-interferon, IL-2) which we see in early MF lesions, to a Th2 response. As patients develop Sezary syndrome, peripheral eosinophilia develops.
Two cytokines, IL-10 and IL-12 may be important in shifting this parameter.
Sezary syndrome patients have characteristic biological markers. They usually have high CD4 to CD8 ratios, usually greater that six to one.
Their disease appears to be Th2 predominant, leading to prominent eosinophilia. Their soluble IL-2 receptors are well above normal. Many have high lactate dehydrogenase(LDH) levels. We have found that low magnesium levels are frequent and correlate with the stage of the disease. We have begun supplementing these patients, but it is not yet clear if this will affect the disease process.
These various biological markers can be used to evaluate response to therapy. Those patients with low quantitative immunoglobulin G levels tend to become infected, though treatment with IV IgG appears to help prevent severe infection."
Toisenlainen näkökulma Th1/Th2 asiaan ihon T-solulymfooman kautta. Borrelioosin tavoin myös siinä tavataan matalia magnesiumpitoisuuksia. Henkilöt joilla on alhainen IgG-arvo sairastuvat helpommin. Immunoglobuliinihoito (IV IgG) näyttäisi auttavan:
Current treatment of Cutaneous T-Cell Lymphoma
Madeleine Duvic MD
Dermatology Online Journal 7(1): 3
University of Texas, MD Anderson Cancer Center
It is now appreciated that as patients progress from Stage I to Stage III (erythrodermic) or IV (nodal effacement) there is a shift in the immune response from the Th1 response (gamma-interferon, IL-2) which we see in early MF lesions, to a Th2 response. As patients develop Sezary syndrome, peripheral eosinophilia develops.
Two cytokines, IL-10 and IL-12 may be important in shifting this parameter.
Sezary syndrome patients have characteristic biological markers. They usually have high CD4 to CD8 ratios, usually greater that six to one.
Their disease appears to be Th2 predominant, leading to prominent eosinophilia. Their soluble IL-2 receptors are well above normal. Many have high lactate dehydrogenase(LDH) levels. We have found that low magnesium levels are frequent and correlate with the stage of the disease. We have begun supplementing these patients, but it is not yet clear if this will affect the disease process.
These various biological markers can be used to evaluate response to therapy. Those patients with low quantitative immunoglobulin G levels tend to become infected, though treatment with IV IgG appears to help prevent severe infection."