The Experts below are selected from a list of 126 Experts worldwide ranked by ideXlab platform

Allen C. Steere - One of the best experts on this subject based on the ideXlab platform.

  • Erythema Chronicum Migrans and Lyme Arthritis
    Annals of Internal Medicine, 2020
    Co-Authors: Allen C. Steere, Stephen E. Malawista, John A. Hardin, Shaun Ruddy, Philip W. Askenase, Warren A. Andiman
    Abstract:

    Abstract Thirty-two patients with the onset of Erythema Chronicum Migrans, Lyme arthritis, or both in mid-1976 were studied prospectively. The skin lesion (24 patients) typically lasted about 3 wee...

  • Chronic Lyme Arthritis
    Annals of Internal Medicine, 2020
    Co-Authors: Allen C. Steere, John A. Hardin, Allan Gibofsky, Manuel E. Patarroyo, Robert Winchester, Stephen E. Malawista
    Abstract:

    Abstract Ten patients with Lyme arthritis have developed chronic involvement of one or both knees. Lyme arthritis was diagnosed by onset with Erythema Chronicum Migrans (six patients); residence in...

  • Published Monthly by the American College of Physicians Erythema Chronicum Migrans and Lyme Arthritis The Enlarging Clinical Spectrum
    2016
    Co-Authors: Allen C. Steere, M. D. Stephen, E. Malawista, F. A. C. P. John, A. Hardin
    Abstract:

    Thirty-two patients with the onset of Erythema Chronicum Migrans, Lyme arthritis, or both in mid-1976 were studied prospectively. The skin lesion (24 patients) typically lasted about 3 weeks, beginning as a red macule or papule that expanded to form a large ring with central clearing. Associated symptoms ranged from none to malaise, fatigue, chills and fever, headache, stiff neck, backache, myalgias, nausea, vomiting, and sore throat. Three patients had been bitten by ticks at the site of the initial lesion 4 to 20 days before its onset. Nineteen patients suddenly developed a monoarticular or oligoarticular arthritis 4 days to 22 weeks (median, 4 weeks) after onset of the skin lesion; eight developed arthritis without a preceding skin lesion. Seven of these 27 experienced migratory joint pains. Arthritis attacks, most commonly in the knee, were typically short (median, 8 days) but sometimes persisted for months. Other manifestations included neurologic abnormalties, myocardial conduction abnormalities, serum cryoprecipitates, elevated serum IgM levels, and elevated erythrocyte sedimentation rates. The diagnostic marker is the skin lesion; without it, geographic clustering is the most important clue. LYME ARTHRITIS, a new form of inflammatory arthritis, has been occurring in eastern Connecticut at least since 1972

  • Spirochäten-Ätiologie der Erythema-Chronicum-Migrans-Krankheit
    Deutsche Medizinische Wochenschrift, 2008
    Co-Authors: R Ackermann, H P Boisten, J Kabatzki, Allen C. Steere, Robert L. Grodzicki, S. Hartung, U Runne
    Abstract:

    From ticks of the type Ixodes ricinus, 19 strains of a spirochete were isolated at three places of infection of Erythema Chronicum Migrans disease. The spirochete was immunologically related to Borrelia duttoni, Treponema pallidum and Ixodes dammini spirochete, the causative organism of North American Erythema Chronicum Migrans disease (Lyme disease). The isolated spirochete differed from the North American one in its reaction with monoclonal antibodies and possibly in its electronmicroscopic structure. A corresponding spirochete was isolated from the blood of a woman with Erythema Chronicum Migrans. Of 39 patients with Erythema Chronicum Migrans mostly treated with antibiotics 50% had increased IgG antibody titre (1:64 to 1:1024) against the isolated spirochete, while among 51 untreated patients with tick-transmitted meningopolyneuritis 90% had increased IgG antibody titres. Fourfold antibody titres increases or falls were found on 50 occasions. IgG antibody titres up to 1:64 were demonstrated also in CSF, in 22 instances with significant changes. Increased serum IgM antibody titres of 1:32 to 1:256 were observed in 20% and 68%, respectively, of patients. These findings suggest that the isolated spirochete is the causative agent of Erythema Chronicum Migrans disease in Europe. Its antigen structure and arrangement is similar to that of the causative agent of Lyme disease.

Paivi Nurmilaakso - One of the best experts on this subject based on the ideXlab platform.

  • Successful Amplification of DNA Specific for Finnish Borrelia burgdorferi Isolates in Erythema Chronicum Migrans but Not in Circumscribed Scleroderma Lesions
    The Journal of investigative dermatology, 1994
    Co-Authors: Annamari Ranki, Einari Aavik, Pärt Peterson, Kristiina Schauman, Paivi Nurmilaakso
    Abstract:

    Early diagnosis of Borrelia burgdorferi infection, hampered by the absence of detectable antibodies in most patients with Erythema Chronicum Migrans is important to prevent late-stage neurologic, rheumatologic, and skin disorders. Furthermore, B. burgdorferi has been claimed to be the causative agent in localized scleroderma (morphea). We used PCR amplification to search for B. burgdorferi outer surface protein OspA-specific sequences in DNA obtained from lesional skin biopsies on Finnish patients with clinically suspect Erythema Chronicum Migrans, lymphocytoma, morphea, or with diverse skin manifestations and persistent high antibodies to B. burgdorferi flagellar antigen. Seronegative patients with other skin lesions served as controls. The amplicons obtained with primers specific for B. burgdorferi type strain B31 ospA sequence did not hybridize to the corresponding probes, and thus the DNA amplified from a Finnish B. burgdorferi Erythema Chronicum Migrans skin isolate was sequenced. This 98-nucleotide sequence of ospA (332-429) showed 11% to 14% nucleotide divergence compared with the North American type strain (B31), several European strains, and an East Siberian tick strain. The sequence was almost identical (99%) to a Swedish isolate from acrodermatitis chronica atrophicans. Using oligonucleotides specific for the Finnish strain, a positive polymerase chain reaction-based hybridization was obtained in six of seven untreated Erythema Chronicum Migrans patients infected in Finland or in Estonia, and in the lymphocytoma patient. Only two of the Erythema Chronicum Migrans patients had IgG or IgM antibodies to flagellin. However, all seven morphea lesions as well as the other lesions were polymerase chain reaction negative. Polymerase chain reaction-based hybridization of B. burgdorferi OspA gene from skin-derived DNA thus provides a sensitive and specific diagnostic tool. In conditions not unequivocally known to be caused by B. burgdorferi, like in morphea, this assay was negative. We also demonstrate that peri-Baltic B. burgdorferi isolates show homology in their OspA genes but differ from geographically more distant isolates.

Stephen E. Malawista - One of the best experts on this subject based on the ideXlab platform.

Annamari Ranki - One of the best experts on this subject based on the ideXlab platform.

  • Successful Amplification of DNA Specific for Finnish Borrelia burgdorferi Isolates in Erythema Chronicum Migrans but Not in Circumscribed Scleroderma Lesions
    The Journal of investigative dermatology, 1994
    Co-Authors: Annamari Ranki, Einari Aavik, Pärt Peterson, Kristiina Schauman, Paivi Nurmilaakso
    Abstract:

    Early diagnosis of Borrelia burgdorferi infection, hampered by the absence of detectable antibodies in most patients with Erythema Chronicum Migrans is important to prevent late-stage neurologic, rheumatologic, and skin disorders. Furthermore, B. burgdorferi has been claimed to be the causative agent in localized scleroderma (morphea). We used PCR amplification to search for B. burgdorferi outer surface protein OspA-specific sequences in DNA obtained from lesional skin biopsies on Finnish patients with clinically suspect Erythema Chronicum Migrans, lymphocytoma, morphea, or with diverse skin manifestations and persistent high antibodies to B. burgdorferi flagellar antigen. Seronegative patients with other skin lesions served as controls. The amplicons obtained with primers specific for B. burgdorferi type strain B31 ospA sequence did not hybridize to the corresponding probes, and thus the DNA amplified from a Finnish B. burgdorferi Erythema Chronicum Migrans skin isolate was sequenced. This 98-nucleotide sequence of ospA (332-429) showed 11% to 14% nucleotide divergence compared with the North American type strain (B31), several European strains, and an East Siberian tick strain. The sequence was almost identical (99%) to a Swedish isolate from acrodermatitis chronica atrophicans. Using oligonucleotides specific for the Finnish strain, a positive polymerase chain reaction-based hybridization was obtained in six of seven untreated Erythema Chronicum Migrans patients infected in Finland or in Estonia, and in the lymphocytoma patient. Only two of the Erythema Chronicum Migrans patients had IgG or IgM antibodies to flagellin. However, all seven morphea lesions as well as the other lesions were polymerase chain reaction negative. Polymerase chain reaction-based hybridization of B. burgdorferi OspA gene from skin-derived DNA thus provides a sensitive and specific diagnostic tool. In conditions not unequivocally known to be caused by B. burgdorferi, like in morphea, this assay was negative. We also demonstrate that peri-Baltic B. burgdorferi isolates show homology in their OspA genes but differ from geographically more distant isolates.

J.m.d. Galama - One of the best experts on this subject based on the ideXlab platform.

  • Amplification of Borrelia burgdorferi DNA in skin biopsies from patients with Lyme disease.
    Journal of clinical microbiology, 1991
    Co-Authors: Willem J. G. Melchers, Jacques F. Meis, P Rosa, Eric C. J. Claas, L. Nohlmans, R.j.j. Koopman, Alphons M. Horrevorts, J.m.d. Galama
    Abstract:

    To determine whether the polymerase chain reaction could contribute to a better diagnosis of Lyme disease, skin biopsy samples from patients suffering from Erythema Chronicum Migrans or acrodermatitis chronica atrophicans were tested for the presence of Borrelia burgdorferi by a polymerase chain reaction assay, which was specific for European strains. The spirochete could not be detected microscopically in any of the 15 biopsy samples obtained from nine patients. However, B. burgdorferi could be isolated from seven of eight of these samples, which indicated the presence of spirochetes. Using a nested polymerase chain reaction, we were able to detect B. burgdorferi-specific sequences in 12 of the 15 biopsy samples. Biopsy samples from three of four patients with Erythema Chronicum Migrans and four of five patients with acrodermatitis chronica atrophicans were found to be positive for B. burgdorferi. The spirochete could be isolated from the biopsy sample, from a patient with Erythema Chronicum Migrans who tested negative, which suggests a false-negative polymerase chain reaction result probably on account of the low number of spirochetes present in the lesion. The positive polymerase chain reaction for lesions from patients with acrodermatis chronica atrophicans supports the concept that B. burgdorferi can persist in the skin over a long period of time. From these results, it was concluded that the polymerase chain reaction is a valuable technique for the diagnosis of Lyme disease.