Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0014070 (encephalomyelitis)
 13,017 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Lyme borreliosis is a multisystem disorder common in childhood. It is an acute and persistent anthropozoonotic infection caused by the spirochete Borrelia burgdorferi (Bb) which is transmitted by Ixodes ticks. After the tick bite in summer, erythema migrans, meningoradiculoneuritis, or carditis may develop within the same season. Later manifestations may be oligo-arthritis, progressive encephalomyelitis, or acrodermatitis chronica atrophicans. The most common course is probably asymptomatic. Connatal infection is possible. Diagnosis is established mainly by history and clinical manifestations. The antibody response to Bb can be measured in serum and cerebrospinal fluid. Tests may be false-negative early in the course of the disease or after early treatment. False-positive results may be caused by cross-reactions. Interpretation of test results must also consider unrelated anamnestic titres or asymptomatic infection. Treatment with appropriate antibiotics cures the disease in most patients, however some patients may not respond. The optimal drug has not yet been found. Best prophylaxis is by early removal of the tick from the skin.
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PMID:Childhood Lyme borreliosis in Europe. 222 64

Erythema migrans or Lyme borreliosis may be classified according to 3 stages. Erythema migrans is the typical initial lesion of the disease, often associated with general symptoms. Carditis, meningitis, musculoskeletal symptoms including arthralgia may develop in stage 2; arthritis (arthralgia), acrodermatitis chronica atrophicans (ACA), and encephalomyelitis may occur in stage 3. Borrelial lymphocytoma may be seen either in the early phase of the disease or along with the ACA. However, there is no definite therapeutical concept, so far. We recommend tetracyclines during the first stage, and high doses of penicillin G during stages 2 and 3 as well as for pregnant women.
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PMID:[Clinical aspects of erythema migrans (Lyme) borreliosis]. 329 40

Epidemiology and clinical presentation of Erythema chronicum migrans disease are not well known yet. During a period of only 19 months, serological and clinical investigation of 2955 patients rendered 1106 cases of infection whose widespread incidence was remarkable: of the 328 administration districts of the FRG, 205 were affected. Accordingly, positive antibodies against Borrelia burgdorferi could be demonstrated in an average of 15.7% of the investigated rural population (2830 persons). Typical clinical signs were encountered in 817 of 1106 infected persons. Erythema (458 cases) and meningopolyneuritis (404 cases) were especially prominent. In comparison to Lyme disease the occurrence of arthritis (63 cases), carditis (13 cases) multiple erythema, recurrence, and central nervous symptoms in meningopolyneuritis (10%) were rare. On the other hand, progressive borrelia encephalomyelitis (45 cases) was surprisingly common. Acrodermatitis chronica atrophicans occurred in 72 cases; lymphadenosis benigna cutis in 5 patients. The variability of this disease is demonstrated by the combined syndromes occurring in only 27% of the cases.
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PMID:Erythema chronicum migrans disease in the Federal Republic of Germany. 359 Oct 95

A positive antibody titre against Ixodes-ricinus-Borrelia (burgdorferi), using indirect immunofluorescence or ELISA, could be detected in serum and (or) liquor of 935 (32%) out of a total of 2955 patients between January 1984 and July 1985. In 289 of these cases the typical clinical manifestations were lacking whereas a characteristic disease picture enabled a diagnosis to be made in 171 patients with negative or borderline antibody titres. The 1106 cases of infection observed covered all regions of the country. A typical clinical syndrome was seen in 817 (74%) of these. Most common were erythema chronicum migrans (n = 458) and meningopolyneuritis Garin-Bujadoux-Bannwarth (n = 404); in 42% of the cases meningopolyneuritis was preceded by an erythema. Arthritis (n = 63), acrodermatitis chronica atrophicans (n = 72), carditis (n = 13) and lymphadenosis benigna cutis (n = 5) were much less common. Chronic Borrelian encephalomyelitis (n = 45) appeared surprisingly often (n = 45). The fact that in 73% of cases the various syndromes appeared alone, were double in 24% and combined only in 3%, illustrates the polymorphic nature of this disease.
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PMID:[Erythema migrans borreliosis in the Federal Republic of Germany. Epidemiology and clinical aspects]. 390 25

Lyme borreliosis is the most frequent tickborne++ disease of man in the Northern hemisphere. A variety of systems may be involved. The most frequent manifestations in childhood include erythema migrans, meningitis, cranial nerve palsy and arthritis. Erythema migrans usually is easily recognised and determination of antibodies to Borrelia burgdorferi should not be performed. Childhood neuroborreliosis is characterised mostly by aseptic meningitis with or without cranial nerve palsy, in most cases facial palsy. Basic CSF findings often show a combined evidence of lymphocytic pleocytosis, IgM-class dominance in intrathecal humoral immune++ response, and blood-CSF barrier dysfunction. Calculation of the Borrelia burgdorferi specific antibody index (according to Reiber) proved to be the most sensitive method for detecting intrathecal synthesis of specific antibodies. Lyme arthritis presents initially as episodic oligoarthritis, mostly involving the knee joint, and may turn into chronic monoarthritis of the knee; usually high titers of IgG antibodies to Borrelia burgdorferi are found. The rarer manifestations encephalomyelitis, chronic arthritis, carditis and inflammatory eye disease may be difficult to diagnosis due to clinical ambiguity and problems in the interpretation of serological results. Antibodies to Borrelia burgdorferi found by sensitive Elisa must always be confirmed by immunoblot analysis, but sometimes immunoblot analysis is more sensitive than Elisa. Treatment is by antibiotics, amoxicillin or doxyciclin for erythema migrans, and i.v. third generation cephalosporins for all other manifestations. Even after successful antibiotic therapy, antibodies may persist for months and years and no further antibiotic treatment is necessary in the absence of attributable clinical manifestations. The differentiation between a persisting immune response and a persisting infection therefore has to be based upon the clinical symptoms, non-specific laboratory data and the development of the antibody titers.
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PMID:[Diagnosis and therapy of Lyme borreliosis in children. Practice guideline of the German Society for Pediatric Infectious Diseases]. 1040 14

Organ-specific autoimmune diseases and their animal models are characterized by the finding that the development of the diseases is closely associated with, or induced by, T cells reactive to organ-specific antigens. Therefore, the identification of T cell receptors (TCR) used by disease-inducing T cells within a short period of time is a key factor for designing TCR-based immunotherapy. The findings introduced in this article show that TCR associated with the development of multiple sclerosis and experimental autoimmune diseases including encephalomyelitis (EAE), neuritis (EAN) and carditis (EAC) are identifiable by complementarity-determining region 3 (CDR3) spectratyping analysis and subsequent sequencing of the CDR3 region of spectratype-derived TCR clones. It is also demonstrated that immunotherapy targeting disease-associated TCR using monoclonal antibodies and DNA vaccines significantly reduced the histological severity, and completely suppressed the inflammation in some animals. Since depletion or suppression of one of several types of effector cells does not significantly improve the severity of the disease, combined TCR-based immunotherapy should be considered as a primary therapy for T cell-mediated autoimmune diseases. TCR-based immunotherapy after rapid identification of autoimmune disease-associated TCR by CDR3 spectratyping can be applicable, not only to animal, but also to human autoimmune diseases whose pathomechanism is poorly understood.
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PMID:Characterization of T cell receptor (TCR) of organ-specific autoimmune disease-inducing T cells and TCR-based immunotherapy with DNA vaccines. 1102 29