PERIPETEIAS OF NEUROBORRELIOSIS DIAGNOSTICS
DOI:
https://doi.org/10.11603/1681-2727.2018.1.8681Keywords:
Lyme borreliosis, damage to the nervous system, dermatomyositis, diagnosis, treatment.Abstract
The aim of the work – to describe the case of a manifestation of nоn-erythemal Lyme borreliosis in the form of acute progressive neuroinfection against the background of immunosuppressive therapy, which was designed in connection with the establishment of a patient with dermatomyositis. The breadth of the differential diagnostic search, complicated by some atypism of the debut and the course of dermatomyositis, and the beginning of the observation of patients already on the background of treatment with glucocorticoids is of some interest. An overview of the literature on pathogenesis, clinic and diagnosis of neuroborreliosis is made.
Autoimmune mechanisms with a predominant disorder of humoral response (intrathecal synthesis of anti-borrelium monoclonal antibodies, some of which are similar to myelin) cause myelin degradation and secondary axonal damage to the nervous system, such as the mechanism of «molecular mimicry».
Conclusions. Due to the fact that borrelians are probably involved in the initiation of the autoimmune process as a result of the activation of myelin-specific T cells and the detection of autoimmune antibodies to myelin and the component of myelin, differential diagnosis should take into account the possibility of combining Lyme borreliosis with other autoimmune diseases.
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