A listserv member brought this to the attention of the group today.
Intravenous immunoglobulin therapy helped all of the lyme patients with neuropathy
after 6 months of one treatment per month. You may be put off by the
starting premise of the study -- that their symptoms were part of post-lyme
treatment syndrome -- but the conclusion seemed to be that they still had Lyme or
would not have benefited from the IVIG therapy.
Source: DGNews
Immunoglobulin Therapy Effective for Neuropathy in Patients With
Post-Treatment Lyme Syndrome
Presented at AAN
By Andrew Wilner, MD
SEATTLE, Wash -- May 2, 2009 -- Intravenous immunoglobulin (IVIG) therapy
may improve neuropathic symptoms in patients with post-treatment Lyme
syndrome, researchers stated here on April 28 at the American Academy of
Neurology (AAN) 61st Annual Meeting.
A significant number of patients who had Lyme disease will continue to
have lingering symptoms referred to as post-treatment Lyme syndrome,
according to presenter Amiram Katz, MD, Lambert Professional Center, Orange,
Connecticut. Similar symptoms are seen in patients who have received the Lymerix
vaccine.
The study included 30 patients seen by Dr. Katz (13 females, 17 males;
mean age 48.2 years) who complained of neuropathic pain.
Of the patients, 22 had a history of Lyme disease and 8 patients had
received the Lymerix vaccine. All patients had antibodies to outer surface
protein A (anti-OspA) and persistent symptoms despite at least 1 course of
antibiotics.
Twenty-four patients had electrodiagnostic studies, but there was a poor
correlation between electrodiagnostic and nerve biopsy results.
Four patients with abnormal electrodiagnostic studies had normal epidermal
nerve fibre density on nerve biopsy, while 10 patients with normal
electrodiagnostic studies had abnormal epidermal nerve fibre density on nerve
biopsy. Three patients had inflammatory changes around the nerve endings on
skin biopsy.
All patients were treated with IVIG 2 g/kg per month for at least 6 months.
After IVIG treatment, all patients had improvement of their neurological
examination with respect to their sensation, Achilles reflex, and Romberg
test. Several patients also showed improvement in the number of nerve fibres
on repeat nerve biopsy after treatment. There was no placebo group.
"The diagnosis of chronic Lyme disease is not widely accepted, yet these
patients have symptoms and nerve biopsies that respond to IVIG treatment,
legitimising their complaints," concluded Dr. Katz.
[Presentation title: Diminished Epidermal Nerve Fiber Density in Patients
With Antibodies to Outer Surface Protein A (OspA) of B. burgdorferi
Improves with Intravenous Immunoglobulin Therapy. Abstract P02.021]
after 6 months of one treatment per month. You may be put off by the
starting premise of the study -- that their symptoms were part of post-lyme
treatment syndrome -- but the conclusion seemed to be that they still had Lyme or
would not have benefited from the IVIG therapy.
Source: DGNews
Immunoglobulin Therapy Effective for Neuropathy in Patients With
Post-Treatment Lyme Syndrome
Presented at AAN
By Andrew Wilner, MD
SEATTLE, Wash -- May 2, 2009 -- Intravenous immunoglobulin (IVIG) therapy
may improve neuropathic symptoms in patients with post-treatment Lyme
syndrome, researchers stated here on April 28 at the American Academy of
Neurology (AAN) 61st Annual Meeting.
A significant number of patients who had Lyme disease will continue to
have lingering symptoms referred to as post-treatment Lyme syndrome,
according to presenter Amiram Katz, MD, Lambert Professional Center, Orange,
Connecticut. Similar symptoms are seen in patients who have received the Lymerix
vaccine.
The study included 30 patients seen by Dr. Katz (13 females, 17 males;
mean age 48.2 years) who complained of neuropathic pain.
Of the patients, 22 had a history of Lyme disease and 8 patients had
received the Lymerix vaccine. All patients had antibodies to outer surface
protein A (anti-OspA) and persistent symptoms despite at least 1 course of
antibiotics.
Twenty-four patients had electrodiagnostic studies, but there was a poor
correlation between electrodiagnostic and nerve biopsy results.
Four patients with abnormal electrodiagnostic studies had normal epidermal
nerve fibre density on nerve biopsy, while 10 patients with normal
electrodiagnostic studies had abnormal epidermal nerve fibre density on nerve
biopsy. Three patients had inflammatory changes around the nerve endings on
skin biopsy.
All patients were treated with IVIG 2 g/kg per month for at least 6 months.
After IVIG treatment, all patients had improvement of their neurological
examination with respect to their sensation, Achilles reflex, and Romberg
test. Several patients also showed improvement in the number of nerve fibres
on repeat nerve biopsy after treatment. There was no placebo group.
"The diagnosis of chronic Lyme disease is not widely accepted, yet these
patients have symptoms and nerve biopsies that respond to IVIG treatment,
legitimising their complaints," concluded Dr. Katz.
[Presentation title: Diminished Epidermal Nerve Fiber Density in Patients
With Antibodies to Outer Surface Protein A (OspA) of B. burgdorferi
Improves with Intravenous Immunoglobulin Therapy. Abstract P02.021]
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