RESUMEN
A cohort of family members with various chronic diseases including Crohn's disease, asthma, complex regional pain syndrome, hypothyroidism, type 1 diabetes mellitus, and lymphangiomatosis and/or evidence of infection by Mycobacterium avium subsp. paratuberculosis (MAP) are described in this series of case reports. MAP was cultured from the blood of three members affected by the first five diseases and there was accompanying elevated anti-MAP IgG in two members. The patient affected by the sixth disease has a markedly elevated anti-MAP titer. The two patients affected by the first four diseases have been treated with a combination of anti-MAP antibiotics and ultraviolet blood irradiation therapy with resolution of the disease symptomatology and inability to culture MAP in post treatment blood samples. These case reports of patients with MAP infections provide supportive evidence of a pathogenic role of MAP in humans.
Asunto(s)
Antituberculosos/uso terapéutico , Síndromes de Dolor Regional Complejo/terapia , Enfermedad de Crohn/terapia , Mycobacterium avium subsp. paratuberculosis/efectos de los fármacos , Mycobacterium avium subsp. paratuberculosis/efectos de la radiación , Paratuberculosis/terapia , Terapia Ultravioleta/métodos , Adulto , Técnicas Bacteriológicas , Biopsia , Niño , Colonoscopía , Terapia Combinada , Síndromes de Dolor Regional Complejo/diagnóstico , Síndromes de Dolor Regional Complejo/microbiología , Enfermedad de Crohn/diagnóstico , Enfermedad de Crohn/microbiología , Femenino , Humanos , Masculino , Mycobacterium avium subsp. paratuberculosis/aislamiento & purificación , Paratuberculosis/diagnóstico , Paratuberculosis/microbiología , Paratuberculosis/transmisión , Inducción de Remisión , Resultado del Tratamiento , Adulto JovenRESUMEN
After a short-term fever, complex regional pain syndrome, characterized by hyperalgesia, intermittent swelling, erythema and cyanosis of both feet, was diagnosed in a female veterinarian. The woman was infected with Bartonella koehlerae and she was also Bartonella vinsonii subsp. berkhoffii seroreactive. Having failed other treatments, symptoms resolved following initiation of antibiotics.
Asunto(s)
Infecciones por Bartonella/microbiología , Bartonella/aislamiento & purificación , Síndromes de Dolor Regional Complejo/microbiología , Adulto , Antibacterianos/uso terapéutico , Bartonella/efectos de los fármacos , Bartonella/genética , Infecciones por Bartonella/tratamiento farmacológico , Síndromes de Dolor Regional Complejo/tratamiento farmacológico , Femenino , HumanosRESUMEN
Complex Regional Pain Syndrome (CRPS) is a serious and painful condition involving the peripheral and central nervous systems. Full comprehension of the disorder's pathophysiology remains incomplete, but research implicates the immune system as a contributor to chronic pain. Because of the impact gastrointestinal bacteria have in the development and behavior of the immune system, this study compares the GI microbial communities of 16 participants with CRPS (5 of whom have intestinal discomforts) and 16 healthy controls using 454 sequencing technology. CRPS subjects were found to have significantly less diversity than their healthy counterparts. Statistical analysis of the phylogenetic classifications revealed significantly increased levels of Proteobacteria and decreased levels of Firmicutes in CRPS subjects. Clustering analysis showed significant separation between healthy controls and CRPS subjects. These results support the hypothesis that the GI microbial communities of CRPS participants differ from those of their healthy counterparts. These variations may hold the key to understanding how CRPS develops and provide information that could yield a potential treatment.
Asunto(s)
Bacterias/genética , Síndromes de Dolor Regional Complejo/microbiología , Tracto Gastrointestinal/microbiología , Adulto , Análisis de Varianza , Bacterias/clasificación , ADN/genética , ADN/aislamiento & purificación , Femenino , Genes Bacterianos/genética , Humanos , Masculino , Persona de Mediana Edad , ARN Ribosómico 16S/biosíntesis , Análisis de Secuencia de ADN , Adulto JovenRESUMEN
We hypothesised that some complex regional pain syndromes (CRPS) may have a postinfectious and/or autoimmune basis. Sera from 92 patients with CRPS and 92 controls were investigated for immunoreactivity to Campylobacter strains and to rodent tissues. Both IgA-antibodies to Campylobacter and tissue-specific reactivity were often present in patients with short disease duration (< or = 1.5 years). Patients with minimal preceding trauma had stronger nervous tissue-specific reactivity than other patients, regardless of disease duration. These results provide preliminary evidence for immune activation early in CRPS and, additionally, that patients with minimal trauma may comprise an autoimmune subgroup.