ABSTRACT
Lyme Disease has been called "The New Great Imitator," a replacement for that old "great imitator" neurosyphilis. This article reviews the numerous psychiatric and neurologic presentations found in adults and children. It then reviews the features of Lyme Disease, which makes it almost uniquely hard to diagnose, including the complexity and unreliability of serologic tests. Clinical examples follow that illustrate those presentations of this disease that mimic attention deficit hyperactivity disorder (ADHD), depression, and multiple sclerosis.
Subject(s)
Lyme Disease/diagnosis , Mental Disorders/diagnosis , Adolescent , Adult , Attention Deficit Disorder with Hyperactivity/diagnosis , Blotting, Western/standards , Borrelia burgdorferi Group/pathogenicity , Child , Depression/diagnosis , Diagnosis, Differential , Encephalitis, Tick-Borne/diagnosis , Encephalomyelitis/microbiology , Enzyme-Linked Immunosorbent Assay/standards , Humans , Lyme Disease/therapy , Meningitis, Bacterial/diagnosis , Mental Disorders/therapy , Middle Aged , Multiple Sclerosis/diagnosis , Neuropsychological Tests , Predictive Value of Tests , Serologic Tests/standardsABSTRACT
Pathogenic autoantibodies from patients with systemic lupus erythematosus (SLE) may represent a relatively cationic fraction of IgG. We compared the spectrotype distributions of affinity-purified IgG from the sera of 10 SLE patients and 10 age- and sex-matched control subjects. Purified IgG was subjected to isoelectric focusing between pI 3 and 9. No significant difference was observed for pI 6.0-6.5 and 7.5-8.0. However, control subjects had a higher percent of total IgG at 6.5-7.0 (15.4 +/- 4.0 vs 11.1 +/- 2.0, P = 0.008) and at 7.0-7.5 (22.4 +/- 4.8 vs 18.2 +/- 3.8, P = 0.04) whereas SLE patients had a higher percent of total IgG at 8.0-8.5 (24.3 +/- 3.0 vs 20.5 +/- 4.0, P = 0.03) and at 8.5-9.0 (21.9 +/- 5.9 vs 15.1 +/- 3.7, P = 0.006). Spectrotype distributions of circulating IgG from SLE patients are skewed toward higher pI, providing further evidence of proliferation of B-cell clones that express more cationic IgG in patients with SLE. Longitudinal studies of serum IgG from several patients for > 1 year reveal distinct changes in both cationic and anionic clonotypes, suggesting clonal expansion of antiidiotypes to autoantibodies.
Subject(s)
Autoantibodies/blood , Immunoglobulin G/blood , Isoelectric Focusing , Lupus Erythematosus, Systemic/immunology , HIV Infections/immunology , Humans , Immunoblotting , Isoelectric PointABSTRACT
We have determined the nucleotide sequences of the variable regions of H and L chains of a monoclonal antibody 98QQ that interacts with the thyroid hormone triiodo-L- thyronine with high affinity. Analysis of the nucleotide sequence of the light chain V region of 98QQ revealed that the VL sequence is 99% identical to Balb/c germline Vk 21-E sequence. That is an interesting finding with this high affinity anti-T3 antibody, since occurence of predominantly germline variable region sequences is observed in some autoantibodies to self antigens but not usually in high affinity IgG antibodies. The sequence analysis also revealed that the heavy chain variable region sequence of 98QQ is similar to a V region of an anti-DNA antibody (MRL DNA 22). Thus the sequence analysis of our anti-T3 mAb 98QQ has revealed some features of autoantibodies to self antigens.
Subject(s)
Antibodies, Monoclonal/chemistry , Genes, Immunoglobulin , Triiodothyronine/immunology , Amino Acid Sequence , Animals , Antibodies, Monoclonal/immunology , Autoantibodies/chemistry , Base Sequence , Immunoglobulin Heavy Chains/chemistry , Immunoglobulin Heavy Chains/genetics , Immunoglobulin Light Chains/chemistry , Immunoglobulin Light Chains/genetics , Immunoglobulin Variable Region/chemistry , Immunoglobulin Variable Region/genetics , Mice , Molecular Sequence DataABSTRACT
The macromolecular polymer, methyl cellulose (MC), is a known hepatosplenomegalic agent which promotes a state of experimental hypersplenism in rats. This is characterized by massive splenomegaly, pancytopenia of the blood elements, medullary hypoplasia, and marked gross and histologic alteration of the liver, kidney, adrenals, and lungs. Massive splenomegaly results from storage of this inert material by splenic macrophages. In the present study, chronic MC administration in rats augmented the hepatic Ep response to hypoxia but did not appreciably affect renal production of Ep. Splenectomy resulted in a decrease in the extrarenal Ep response to hypoxia indicating a possible role of the massively enlarged spleen of these MC-treated rats in extrarenal Ep production. The augmentation of extrarenal Ep elaboration may be attributed to a stimulatory effect of MC on the hepatic and splenic macrophages.
