posted 03 February 2005 09:42               

This phenomenon, first described by Herxheimer in cases of syphilis treated with mercury, also occurs in diseases due to organisms more complex than bacteria when drugs that kill the causative organism in the tissues are administered. This "Herxheimer reaction" is due to the liberation of irritant and antigenic substances from the dying organisms and is not observed in healthy persons or in rheumatoid patients given antibiotics. Its occurrence in rheumatoid disease (including those of autoimmune lesions) treated with various antiamoebic drugs proves that a causative pathogenic amoeba is present in the affected tissues. [Since anti-amoebic medication is also known to kill friendly bacteria, increased accumulations of acetaldehyde byproducts from population explosions of Candida albicans could also account for what was thought to be a Herxheimer reaction. Ed. S.C.] After administration of antiamoebic drugs (especially 5-nitroimidazoles), evidence of rheumatoid disease activity usually completely disappears in both joints and extra-articular tissues within 3 to 6 months. Therefore, autoimmune lymphocytic and humoral reactions are not the primary disturbance in rheumatoid and autoimmune diseases; they are the cellular-antibody response to infection and its antigens and contribute to the tissue damage.