KROONINEN FATIIKKI/BORRELIOOSI

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Lähettäjä: Soijuv Lähetetty: 3.11.2004 12:44

Vaikeat väsymisoireet ovat tavallinen oire kroonisessa borrelioosissa. Lokakuussa olleessa CFS (krooninen fatiikki) -kongressissa N. Schwartzilta kysyttiin ovatko CFS ja krooninen borrelioosi yksi ja sama asia. Vastauksessa on useita kyseenalaisia kannanottoja - kuten hänen jaottelunsa myöhäisvaiheen ja krooniseen borrelioosiin. Mielenkiintoista oli sen sijaan hänen mielipiteensä siitä että USA:ssa ja Euroopassa on erilainen borrelioosi. Mielenkiintoiseksi asian tekee se, että hän esitti tämän kommentin saksalaisen D. Hasslerin tutkimustuloksista, jossa todettiin potilaiden parantuneen pitkillä antibioottihoidoilla. Hänen mielestään tuloksia ei voi välttämättä käyttää Amerikassa koska Euroopassa on erilainen borrelioosi.

Suomalaiset lääkärit sen sijaan esittävät asian niin että amerikkalaisia tutkimuksia/hoitoja ei voida soveltaa samasta syystä täällä. Missä maassa tehtyjä tutkimustuloksia täällä ja Amerikassa voi soveltaa? Näyttää siltä että erilaisiin borreliabakteerin alalajeihin vetoaminen on enemmänkin syy olla välittämättä tutkimustuloksista.


?Are CFS and Chronic Lyme One and the Same?? asked Dr. Stanley N. Schwartz, MD, director of The Warren Clinic in Tulsa, Oklahoma and current vice-president of the AACFS. Schwartz hastened to state that Oklahoma did not have many cases of Lyme, but he had been asked to overview the existing literature to see how likely there was to be an overlap of Lyme and cfs. In reviewing the literature Schwartz set four limiting guidelines.

¨ Only randomized controlled trials

¨ Only observational studies

¨ Only expert published opinion

¨ Only available in Medline

He added the caveat, ?The plural of anecdote is not data.? ? Kotsonis

?Experience without measurement is not data.? ? Schwartz

[This did not bode well for my later comment that three of us in my family were now positive for borrelia in a state, South Carolina, where supposedly Lyme is not prevalent. I was to be both anecdotal and from a state not considered a Lyme state. One of the CDC doctors told the conference that Lyme in the southeast is a different strain of borrelia and is a mild disease lasting only three weeks. I did make the point that my particular southeastern version of borrelia was a severe illness that had already lasted at least years.]

Schwartz drew a distinction between late Lyme and chronic Lyme. This distinction was that late Lyme had objective signs and serologic confirmation. Chronic Lyme only had serologic confirmation in some cases and no reliable objective signs. His comments on which serology was reliable are as follows:

¨ Reliable: ELISA, western blot, skin culture, synovial fluid PCR

¨ Unreliable: urinary antigen assay, borreliacidal antibody, VisE, PCR, immune complex disruption, t-cell proliferative response to borrelia antigens.

If the patient had a classic Lyme rash that would be helpful, but one would still be diagnosed with CFS if there was no positive serology. Schwartz presented four studies. The first, Klempner (N Engl J Med, 2001, Jul 12;345(2):85-92) http://content.nejm.org/cgi/content/abstract/345/2/85 may indicate that 3 month treatment with antibiotics will not cure Lyme disease, but it does not indicate whether there is such a thing as late Lyme or chronic Lyme. Without a clear transition his presentation moved from considering if there were such a thing as ongoing chronic borrelia infection to whether longterm antibiotics would treat whatever these patients actually had. The conclusion of the presentation was ?Basically an unresolved issue? It was not clear which issue or both were unresolved. A study from Germany by D. Hassler showed that patients did recover with longterm antibiotics, but one of Schwartz?s conclusions was that European borreliosis may be different from US borreliosis.

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Lähettäjä: Soijuv Lähetetty: 3.11.2004 13:00

Edellinen luento ym. luentoja väsymisoireyhtymästä löytyy seuraavalta sivulta:

http://www.meactionuk.org.uk/AACFS_2004_Report.htm

Luennolla esitettiin myös Marshallin teoria, jonka mukaan sarkoidoosin aiheuttavat solunsisäiset mikrobit kuten borreliabakteeri ja mykoplasma. Hän hoitaa tilaa Olmesartanilla ja hoidossa tulee välttää D-vitamiinin saantia, esim. auringonottoa, jonkin aikaa kunnes tilanne on saatu tasapainoon (auringon välttäminen ei Suomessa ole kovinkaan vaikeaa).


Trevor Marshall, PhD, developed a treatment protocol for sarcoidosis patients. His research indicates that sarcoidosis and CFS are caused by intracellular pathogens such as borrelia and mycoplasmas among others. These pathogens increase the secosteroid hormone 1,25 D levels in the body in order to avoid detection by the immune system. By using an angiotensin-II blockade and temporarily avoiding vitamin D sources one can lower the D hormone level. Then a low dose, pulsed, appropriate antibiotic is added to aid the immune system in killing the pathogens. For more information visit

http://www.marshallprotocol.com

Marshallille voi kirjoittaa seuraavaan osoitteeseen:

Trevor.m@yarcrip.com