All Posts Tagged With: "Immunoglobulin M"

Full article: http://jama.ama-assn.org/cgi/content/full/303/21/2132?etoc

Tick-borne encephalitis virus (TBEV) is the most common arbovirus transmitted by ticks in Europe. Approximately 10,000 cases of tick-borne encephalitis (TBE) are reported annually in Europe and Russia.¹ Although TBE is endemic in parts of China, information regarding its incidence is limited.^1–2 TBEV is closely related to Powassan virus (POWV), another tick-borne flavivirus that is a rare cause of encephalitis in North America and Russia; TBEV and POWV can cross-react in serologic tests.^3–4 Before 2000, two cases of TBE in North American travelers to Europe were reported.^5–6 State health officials or clinicians send specimens from patients with unexplained encephalitis to CDC as part of routine surveillance and diagnostic testing. CDC recently reviewed all 2000-2009 laboratory records to identifycases of TBE among U.S. travelers; the five cases identified are summarized in this report. All five cases had TBEV or POWV immunoglobulin M (IgM) antibodies in serum and were confirmed as acute TBE cases by plaque-reduction neutralization tests against both viruses. All four patients who had traveled to Europe or Russia had biphasic illnesses (a common feature of TBE) and made nearly complete recoveries. The fifth patient, the first reported case of TBE in a U.S. traveler to China, had a monophasic illness with severe encephalitis and neurologic sequelae. Health-care providers should be aware of TBE, should counsel travelers about measures to reduce exposure to tick bites, and should consider the diagnosis of TBE in travelers returning from TBE-endemic countries with meningitis or encephalitis.

Excerpt:

Lyme disease (borreliosis) is a systemic illness resulting from infection
with the spirochete Borrelia burgdorferi. It is transmitted to humans by the
bites of infected ticks belonging to several species of the genus Ixodes.
After the bacteria enter the body via the dermis, most patients develop the
early, localised form of Lyme disease, which is characterised by erythema
migrans and influenza-like symptoms. This disease may also affect the heart,
nervous system and joints. The neurological findings of this disease may
include peripheral and central nervous system signs.
A 21-year-old woman attended a family medicine outpatient clinic complaining
of unexplained pain and muscle power loss in her lower extremities. The
problem had started in her right leg 3 months earlier and worsened in the
last week. She had a neurology consultation and was hospitalised. Her
neurological examination revealed bilateral facial paralysis and sensory
impairment. Immunoglobulin M antibody to B. burgdorferi was positive on
Western blotting in both serum and cerebrospinal fluid. The patient was
diagnosed with subacute neuroborreliosis and treated.

Acta Neurol Belg. 2009 Dec;109(4):326-9.

Koc F, Bozdemir H, Pekoz T, Aksu HS, Ozcan S, Kurdak H.

Department of Neurology, Cukurova University School of Medicine, Adana,
Turkey.
koc.filiz@gmail.com