Gila L, Guerrero A, Astarloa R, Martí P, Gutiérrez J M
Servico de Neurología, Hospital Ramón y Cajal, Madrid.
Enferm Infecc Microbiol Clin. 1990 Jan;8(1):32-5.
Several syndromes derived from the involvement of central and peripheral nervous system and meninges have been reported in the infection by Borrelia burgdorferi. The features of autonomic nervous system involvement have received a marginal attention. Reflex sympathetic dystrophy is an autonomic picture characterized by regional sympathetic hyperactivity which has not been associated with Lyme disease. We report a 16-year-old female with clinical, radiological and scintigraphic features consistent with reflex sympathetic dystrophy. The usual causes of this syndrome were ruled out and antibodies against Borrelia burgdorferi were detected by immunofluorescence, enzyme immunoassay and Western blotting. Specific IgG and IgM levels had a progressive increase during three months. In Lyme borreliosis causes of false positives were excluded. Antigen-antibody bands were detected in increasing number during the evolution, using sonicates of B. burgdorferi and patient's sera with the Western blotting technique. Our data suggest that reflex sympathetic dystrophy is another type of nervous system involvement in the multifaceted Lyme borreliosis.
据报道，伯氏疏螺旋体感染可引发几种累及中枢神经系统、周围神经系统和脑膜的综合征。自主神经系统受累的特征很少受到关注。反射性交感神经营养不良是一种以局部交感神经过度活跃为特征的自主神经症状，此前未发现与莱姆病有关。我们报告了一名16岁女性，其临床、放射学和闪烁扫描特征与反射性交感神经营养不良相符。排除了该综合征的常见病因，并通过免疫荧光、酶免疫测定和蛋白质印迹法检测到了抗伯氏疏螺旋体抗体。在三个月内，特异性IgG和IgM水平逐渐升高。排除了莱姆病螺旋体病假阳性的原因。采用蛋白质印迹技术，用伯氏疏螺旋体超声裂解物和患者血清进行检测，在病程中检测到的抗原-抗体条带数量不断增加。我们的数据表明，反射性交感神经营养不良是多方面的莱姆病螺旋体病累及神经系统的另一种类型。
