Revista Brasileira de Reumatologia Print version ISSN 0482-5004 Rev. Bras. Reumatol. vol.49 no.5 S�o Paulo Sept./Oct. 2009
ABSTRACT
INTRODUCTION: Lyme disease (LD) is a tick-borne disease, caused by Borrelia burgdorferi sensu lato spirochetes, transmitted by Ixodes ricinus complex ticks, which leads to multiple systemic clinical manifestations.
In Brazil, a different syndrome is described that mimics LD symptoms, but that also manifests high frequencies of recurrent episodes and immune-allergic manifestations.
It is transmitted by the Amblyomma cajennense tick and the etiological agent is an uncultivable spirochete with atypical morphology.
Due to its particularities, this emerging zoonosis has been called Brazilian LD-like syndrome or Baggio-Yoshinari Syndrome (BYS). OBJECTIVE: To describe the neurological spectrum of BYS.
PATIENTS: Thirty patients with neurological symptoms of BYS were analyzed. RESULTS: Mean age of patients was 34.2 � 13.3 years old (6 to 63 years); 20 were females and 10 males.
A high number of recurrent episodes (73.6%) and severe psychiatric or psycho-social disturbances (20%) were distinguishing features.
Erythema migrans similar to those seen in the Northern hemisphere was identified in 43.3% of patients at disease onset.
The recurrence of skin lesions diminished as the disease progressed. Articular symptoms (arthritis) happened in nearly half of patients at BYS onset and during relapsing episodes.
CONCLUSIONS: The BYS is considered a new tick borne disease in Brazil that differs from classical LD observed in the Northern hemisphere.
BYS replicates most of the neurological symptoms observed in LD, except for the additional presence of relapsing episodes and the tendency to cause chronic neurological and articular manifestations.
"In conclusion, BYS replicates most of the neurological symptoms observed in LD, except for the additional presence of relapse episodes and the tendency to cause chronic neurological and articular manifestations.
The understanding of BYS of interest for various disciplines of different specialties, because it is a new tick borne disease, completely different from classical LD.
Furthermore, since this zoonosis RELAPSES, PROGRESSES and develops autoimmune features, it brings serious differential diagnostic concerns with chronic idiopathic rheumatic and neurological syndromes."
AND a researcher dispatched to Brasil by Steere:
"A Long Journey to Understand Borrelia burgdorferi in Brazil"
![[Wink]](wink.gif)