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» LymeNet Flash » Questions and Discussion » Computer Questions » ILADS

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Author Topic: ILADS
treepatrol
Honored Contributor (10K+ posts)
Member # 4117

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WESTERN BLOT IN LYME
* Reflects antibody response to specific Bb
antigens- they are reported as numbers
called ``bands''
* Some bands are seen in many different
bacteria- ``nonspecific bands''
* Some bands are specific to spirochetes
* Some bands are specific to Bb


WESTERN BLOT IN LYME
* Positive blot contains bands specific for
Lyme
* Specific: 18, 21-24, 31, 34, 37, 39, 83 & 93
* Spirochetes in general: 41
* Nonspecific: All others!
* The more specific bands that are present,
the more sure the diagnosis


PITFALLS OF THE WESTERN
BLOT
* Very difficult to produce and interpret a
western blot
* Bands do not easily line up
* Appearance affected by subtle changes in
temperature and chemistry of the test system
* The specific strain of Bb used to produce the
antigens may not match the strain the patient
has!



HOW DO YOU MAKE THE
DIAGNOSIS?
* Lyme is a clinical diagnosis
* Even the best Lyme tests are only an
adjunct
* Use the ILADS point system


POINT SYSTEM
* Tick exposure in an endemic region 1
* History consistent with Lyme 2
* Systemic signs & symptoms consistent with Bb infection
(other potential diagnoses excluded):
* Single system, e.g., monoarthritis 1
* Two or more systems 2
* Erythema migrans, physician confirmed 7
* ACA, biopsy confirmed 7
* Seropositivity 3
* Seroconversion on paired sera 4
* Tissue microscopy, silver stain 3
* Tissue microscopy, monoclonal IFA 4
* Culture positivity 4
* B. burgdorferi antigen recovery 4
* B. burgdorferi DNA/RNA recovery 4

POINT SYSTEM
DIAGNOSIS
* Lyme Borreliosis Highly Likely
- 7 or above
* Lyme Borreliosis Possible
- 5-6
* Lyme Borreliosis Unlikely
- 4 or below


CO-INFECTIONS IN LYME
* Bartonella
* Babesia
* Ehrlichia
* Mycoplasma
* Viruses
* ?Others


Bartonella
* More ticks in NE contain Bartonella than
contain Lyme
* Clinically, seems to be a different species
than ``cat scratch disease''
* Gastritis and rashes, CNS, seizures, tender
skin nodules and sore soles
* Tests are insensitive! (serologies and PCR)
* Levofloxacin (Levaquin) is drug of choiceconsider
adding proton pump inhibitor

PIROPLASMS
(Babesia species)
* Many different species found in ticks (13+)
* Not able to test for all varieties
* WA-1 more difficult to treat than B. microti
* Diagnostic tests insensitive
* Chronic persistent infection documented
* Infection is immunosuppressive

Ehrlichia
* Can cause acute and chronic presentations
* Acute- sudden high fever, severe headaches,
very painful muscles, low WBC counts,
elevated liver enzymes
* Chronic- same, but not as severe
* Test with serology, PCR or smear
* Treat with doxycycline or rifampin

Mycoplasma
* ``Chronic fatigue'' germ
* Not clear its origin or source
* More often seen in the immunosuppressed
* Test with PCR
* Treat with doxycycline and add
fluoroquinolone
* Erythromycins & rifampin, with added
hydroxychloroquine OK but less effective

Other Co-infections
* Especially in the immunosuppressed
* Chlamydiae
* Viruses
- HHV-6, CMV, other herpes
* Yeasts
* Others


DANGEROUS MIX!
* Co-infections missed in Lyme patients
* Co-infected patients more ill
* Babesiosis and Ehrlichiosis can be fatal!
* Lyme treatments do not treat Babesia or
Bartonella
* One reason for ``treatment-resistant'' Lyme
* ``Silent infections'' may be transmitted by
transfusions

ASSOCIATED CONDITIONS
Neurally Mediated Hypotension
* Dehydration, autonomic neuropathy,
pituitary insufficiency
* Paradoxical response to adrenaline
- profound fatigue
- adrenaline rushes and palpitations
- unavoidable need to lie down
* Diagnose with tilt table test performed by a
cardiologist, and pituitary function tests


ASSOCIATED CONDITIONS
Hormonal Dysfunction
* Significant disturbance of the
hypothalamic-pituitary axis
* Extremely difficult to diagnose
* When corrected, are tremendous benefits!
* A major key to the debility in chronic Lyme


ASSOCIATED CONDITIONS
Hormonal Dysfunction
* Chronic lack of stamina
* Loss of libido
* Intolerance of stress including Herxheimers!
* Unexplained weight gain
* Hypersensitivity to the environment
* Persistent encephalopathy despite Lyme
treatment


ASSOCIATED CONDITIONS
Borrelia Neurotoxin
* Effects
- Neurologic dysfunction
- Cytokine activation
- Hormone receptor blockade
* Testing for neurotoxin:
- Visual contrast sensitivity test
- Measure cytokine levels
- Test for insulin resistance
* Treat with bile acid sequestrants

ASSOCIATED CONDITIONS
Cerebral Vasculitis
* Contributes to encephalopathy
* Vascular headaches
* Seen on SPECT brain scans


SPECT BRAIN SCANS
* Reflects blood flow and health of the
nerve cells
* Pre and post-Diamox scans
* Proves the symptoms are real!
* Useful in differentiating Lyme Disease from
a psychogenic illness
* Can be done serially to reflect clinical
changes

SUPPORTIVE THERAPY
* NUTRITIONAL SUPPORT
- Blend of multivitamins, B-complex, CoEnzyme Q-10,
and magnesium
- Essential fatty acids
- Low glycemic index, high fiber diet
- Absolutely no alcohol
* MANAGE YEAST OVERGROWTH
- Oral hygiene, acidophilus/yogurt
- Low carbohydrate diet
J

SUPPORTIVE THERAPY
METHYLCOBALAMIN
* Prescription drug derived from vitamin B12
- Aids in healing the central and peripheral nervous
system
- Documented benefit in strength, energy and cognition
- Helps restore normal day-night cycle
- Improves T-cell immune responsiveness
* Must be injected daily for 3 to 6 months
* Available only as a ``compounded drug''
* Excellent safety profile


SUPPORTIVE THERAPY
* ENFORCED REST; NO CAFFEINE
- Must try to prevent afternoon energy sags
- Proper sleep is essential
* REHAB AND EXERCISE PROGRAM
- Required for a full recovery
- Intermittent program one to three days per week
- Toning, stretching, posture, balance
- Aerobics are not allowed until nearly fully recovered

ALTERNATIVE THERAPIES
POSSIBLY HELPFUL
* Immune modulation
- Reishi spore extract, transfer factor
- IVIG only if deficient
* Vitamin C
* Acupuncture
ALTERNATIVE THERAPIES
NO PROVEN BENEFIT
* Colloidal silver
* Heat therapy
- Sauna, infrared, hot tubs
* Rife machines


YOUR DUTY AS A LYME
PATIENT
* Political awareness and activity
- Join support groups and be pro-active
- Be willing to participate in events
- Support the major Lyme organizations- ILADS,
LDA, LDF
* Fundraising!!!
* Aggressively spread the truth especially to the media
* Never give up, and never go away until our goals are
met

--------------------
Do unto others as you would have them do unto you.
Remember Iam not a Doctor Just someone struggling like you with Tick Borne Diseases.

Newbie Links

Posts: 10564 | From PA Where the Creeks are Red | Registered: Jun 2003  |  IP: Logged | Report this post to a Moderator
treepatrol
Honored Contributor (10K+ posts)
Member # 4117

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cave i put it here so i could link to it in newbie links under western blot section.

--------------------
Do unto others as you would have them do unto you.
Remember Iam not a Doctor Just someone struggling like you with Tick Borne Diseases.

Newbie Links

Posts: 10564 | From PA Where the Creeks are Red | Registered: Jun 2003  |  IP: Logged | Report this post to a Moderator
WildCondor
Unregistered


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Why is this forum not moderated or organized? hello?
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