Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A-59-year-old Japanese woman presented a cellulitis-like erythematous skin rash, low-grade fever, and general fatigue, accompanied by a firm swelling of the right parotid gland. She had a history of tick bite on the right lateral neck 2 weeks before. Serum anti-Borrelia burgdorferi antibody was positive by Western blot analysis, and B. burgdorferi was isolated from the skin lesion. Serum amylase level was elevated with predominant salivary gland isozyme; the level returned to normal within 3 weeks following penicillin and tetracycline treatment. Parotitis might be included among the rare complications of Lyme disease affecting the head and neck region.
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PMID:A case of Lyme disease with parotitis. 987 81

Chronic fatigue syndrome (CFS) and Lyme disease often share clinical features, especially fatigue, contributing to concern that Borrelia burgdorferi (Bb), the cause of Lyme disease, may underlie CFS symptoms. We examined 39 CFS patients and 40 healthy controls with a Bb immune complex test. Patients and controls were nonreactive. Centers for Disease Control and Prevention-defined CFS patients lacking antecedent signs of Lyme disease--erythema migrans, Bell's palsy, or large joint arthritis--are not likely to have laboratory evidence of Bb infection.
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PMID:Absence of Borrelia burgdorferi-specific immune complexes in chronic fatigue syndrome. 1052 96

Several authors have reported a chronic fatigue-like syndrome in patients that have suffered from Lyme borreliosis in the past. To further investigate this suspicion of an association without sample bias, we carried out a prospective, double-blind study and tested 1, 156 healthy young males for Borrelia antibodies. Seropositive subjects who had never suffered from clinically manifest Lyme borreliosis or neuroborreliosis showed significantly more often chronic fatigue (p = 0.02) and malaise (p = 0.01) than seronegative recruits. Therefore we believe it is worth examining whether an antibiotic therapy should be considered in patients with chronic fatigue syndrome and positive Borrelia serology.
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PMID:Chronic fatigue syndrome in patients with Lyme borreliosis. 1068 69

Lyme borreliosis is a worldwide, multistage, and multi-system disease caused by borrelia spirochetes, which are transmitted by ixodes ticks. It is focally endemic in temperature climates of the northern hemisphere. Primary erythema migrans occurs at the site of inoculation. Secondary erythema migrans occurs at sites of hematogenous dissemination. Variations in genospecies account for variations in presentation, including borrelial lymphocytoma. Disseminated disease includes constitutional signs and symptoms, intermittent oligoarticular arthritis, meningitis, cranial neuritis, radiculoneuropathy, encephalopathy, atrioventricular block, and myopericarditis. Late persistent disease includes acrodermatitis chronica atrophicans, chronic arthritis, neurological impairment, and fatigue. There can be difficulties with both clinical and laboratory diagnosis. First-line oral therapies for early uncomplicated disease are doxycycline and amoxicillin. First-line intravenous therapy for complicated or resistant disease is ceftriaxone. Prevention includes avoiding tick habitats, dressing sensibly, judicious use of repellants, and early removal of imbedded ticks. Vaccination is indicated only for frequent or prolonged exposure to tick-infested habitat.
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PMID:Lyme borreliosis. 1083 3

Lyme disease, which is caused by Borrelia burgdorferi and transmitted in the United States primarily by Ixodes scapularis (the deer tick), is the most common vector borne disease in the United States. Its most frequent manifestation, a characteristic, expanding annular rash (erythema migrans), sometimes accompanied by myalgia, arthralgia, and malaise, occurs in nearly 90% of persons with symptomatic infection. Other manifestations of Lyme disease include seventh cranial nerve palsy, aseptic meningitis, and arthritis. Extensive coverage in the press about the serious effects of Lyme disease has led to widespread anxiety about this illness that is far out of proportion to the actual morbidity that it causes. This problem is exacerbated by the frequent use of serological tests to eliminate the possible diagnosis of Lyme disease in persons with only nonspecific symptoms (such as arthralgia or fatigue) who have a very low probability that Lyme disease is the cause of their symptoms. Consequently, misdiagnosis is frequent and is the most common cause of failure of treatment. The prognosis for most persons with Lyme disease is excellent.
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PMID:Lyme disease. 1098 18

Erythema migrans, the characteristic skin manifestation of acute Lyme borreliosis, is a self-limited lesion. In contrast, acrodermatitis chronica atrophicans, the typical cutaneous manifestation of late Lyme borreliosis, is a chronic skin condition. In an effort to understand pathogenic factors that lead to different outcomes in dermatoborrelioses, skin biopsy samples from 42 patients with erythema migrans and 27 patients with acrodermatitis chronica atrophicans were analyzed for mRNA expression of five pro-inflammatory cytokines (tumor necrosis factor alpha, interleukin-1 beta, interleukin-6, interferon-gamma, and interleukin-2) and two anti-inflammatory cytokines (interleukin-4 and interleukin-10) by in situ hybridization with cytokine-specific riboprobes. Among the 27 patients who had erythema migrans alone with no associated signs or symptoms, the major cytokines expressed in perivascular infiltrates of T cells and macrophages were the pro-inflammatory cytokine interferon-gamma and the anti-inflammatory cytokine interleukin-10. In the 15 erythema migrans patients who had associated signs and symptoms, including headache, elevated temperature, arthralgias, myalgias, or fatigue, a larger number of macrophages and greater expression of macrophage-derived pro-inflammatory cytokines, tumor necrosis factor alpha, interleukin-1 beta, and interleukin-6, were also found. In comparison, infiltrates of T cells and macrophages in the skin lesions of acrodermatitis chronica atrophicans patients had very little or no interferon-gamma expression. Instead, they usually expressed only the pro-inflammatory cytokine tumor necrosis factor alpha and the anti-inflammatory cytokine interleukin-4. Thus, the activation of pro-inflammatory cytokines in erythema migrans lesions, particularly interferon-gamma, seems to be important in the control of the spirochetal infection. In contrast, the restricted pattern of cytokine expression in acrodermatitis chronica atrophicans, including the lack of interferon-gamma, may be less effective in spirochetal killing, resulting in the chronicity of this skin lesion. J Invest Dermatol 115:1115-1123 2000
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PMID:Differential expression of cytokine mRNA in skin specimens from patients with erythema migrans or acrodermatitis chronica atrophicans. 1112 Nov 50

Although neurologic Lyme disease is known to cause cognitive dysfunction in adults, little is known about its long-term sequelae in children. Twenty children with a history of new-onset cognitive complaints after Lyme disease were compared with 20 matched healthy control subjects. Each child was assessed with measures of cognition and psychopathology. Children with Lyme disease had significantly more cognitive and psychiatric disturbances. Cognitive deficits were still found after controlling for anxiety, depression, and fatigue. Lyme disease in children may be accompanied by long-term neuropsychiatric disturbances, resulting in psychosocial and academic impairments. Areas for further study are discussed.
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PMID:A controlled study of cognitive deficits in children with chronic Lyme disease. 1174 19

OBJECTIVE: To investigate the humoral immune status and the effect of antibiotic treatment in Bulgarian patients with early Lyme disease. METHODS: A total of 34 early Lyme disease patients was examined, 16 with erythema migrans and 18 with non-specific systemic symptoms. Serum samples from all patients and from 12 healthy controls were tested for total immunoglobulins (IgG, IgA and IgM), hemolytic activity of complement (CH50) and immune complexes (ICs). The patients were treated with doxycycline (100 mg orally, twice daily for 10 to 15 days, in one or two courses). RESULTS: The patients showed significantly increased IC levels (P<0.01 for patients with erythema migrans and P<0.001 for patients with non-specific symptoms). There were no significant changes in the levels of total hemolytic complement and total immunoglobulins (IgG, IgA and IgM). The clinical outcome was satisfactory in 21 of the 34 patients (61.8%) after treatment with doxycycline for 10 to 15 days. The rest of the patients (38.2%) failed to respond to the therapy, and continued to report various complaints, such as arthralgia, myalgia, paresthesia, headache, fatigue or recurrent rash. All of these had elevated levels of IC. After a second course of treatment with the same antibiotic regimen these patients had resolution of symptoms (12 patients) or improvement (1 patient). CONCLUSIONS: Immunologic investigation may be useful in determining treatment strategy in Lyme disease. Elevated IC levels may indicate a need for more prolonged antibiotic therapy.
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PMID:Early Lyme disease: Humoral immune status and treatment. 1186 74

Lyme disease (LD) is a tick-borne disease that typically presents with myalgia, fatigue, and a characteristic rash. LD occurs worldwide, and its incidence continues to increase. Prevention and early diagnosis based on increased understanding of disease transmission and pathomechanisms are crucial in stopping LD from progressing to its later stages. In this article, the first of a 2-part series on LD, we review epidemiologic and etiologic factors.
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PMID:Lyme disease--part I: epidemiology and etiology. 1204 13

Lyme disease (LD) is the most common vector-borne disease in the United States. Generally presenting with a characteristic rash, myalgia, and fatigue, LD can progress to chronic arthritis, central nervous system manifestations, and cardiac abnormalities, if left untreated. The number of cases continues to rise each year. Early diagnosis and proper therapy are required to halt disease progression to late chronic stages. By adhering to simple guidelines, many potential cases of LD can be prevented. In this article, the second in a 2-part series on LD, we discuss clinical features and treatment.
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PMID:Lyme disease--part II: clinical features and treatment. 1207 46


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