ABSTRACT
OBJECTIVE: To describe clinical cases with neurological manifestations associated with Borrelia burgdorferi infection in a large cohort of children and adults from Mexico. MATERIAL AND METHODS: Patients with neurological manifestation (cranial neuritis, radiculoneuritis, meningitis and encephalomyelitis) were recruited in one pediatric and two general hospitals, during January 2006-December 2015. Blood and cerebrospinal fluid (CSF) samples were drawn from each patient at inclusion. IgM and IgG antibodies against B. burgdorferi were detected using a commercial ELISA test, and confirmed by Western-Blot test (WB) using three different antigens from Borrelia burgdorferi complex. Following CDC criteria were considered true cases with both positive tests. RESULTS: Of 606 patients recruited, 403 (66.5%) were adults and 203 (33.4%) children, 50.5% were male. B. burgdorferi infection was diagnosed in 168 patients (27.7%), 97 adults, mean age 42 ± 14.7 years and 71 children, mean age 9.6 ± 5 years; early disseminated disease occurred in 130 cases (77.4 %) and chronic stage in 38 (22.6 %). A previous tick bite was reported by 21% cases, and 5% recalled an erythema migrans lesion. Polyradiculoneuropathy and encephalomyelitis were the most common manifestations, whereas 14.8% presented an initial Guillain-Barré Syndrome. B. burgdorferi sensu stricto was identified in 142 (84%) cases, B. garinii in 14 (8%), B. afzelii in three, and nine cases presented coinfection with two species. CONCLUSION: Lyme neuroborreliosis is a frequent condition in patients with neurological diseases in Mexico.
Subject(s)
Borrelia burgdorferi/isolation & purification , Encephalomyelitis/pathology , Lyme Neuroborreliosis/epidemiology , Lyme Neuroborreliosis/pathology , Meningitis/pathology , Neuritis/pathology , Radiculopathy/pathology , Adolescent , Adult , Blotting, Western , Child , Child, Preschool , Encephalomyelitis/microbiology , Enzyme-Linked Immunosorbent Assay , Female , Humans , Lyme Neuroborreliosis/microbiology , Male , Meningitis/microbiology , Mexico/epidemiology , Middle Aged , Neuritis/microbiology , Radiculopathy/microbiology , Tick Bites/microbiology , Young AdultABSTRACT
Mitochondrial DNA mutations have been associated with different illnesses in humans, such as Kearns-Sayre syndrome (KSS), which is related to deletions of different sizes and positions among patients. Here, we report a Mexican patient with typical features of KSS containing a novel deletion of 7629 bp in size with 85% heteroplasmy, which has not been previously reported. Sequence analysis revealed 3-bp perfect short direct repeats flanking the deletion region, in addition to 7-bp imperfect direct repeats within 9-10 bp. Furthermore, sequencing, alignment and phylogenetic analysis of the hypervariable region revealed that the patient may belong to a founder Native American haplogroup C4c.
Subject(s)
DNA, Mitochondrial/genetics , Genes, Mitochondrial/genetics , Indians, North American/genetics , Kearns-Sayre Syndrome/genetics , Phylogeny , Sequence Deletion/genetics , Base Sequence , Blotting, Southern , Brain/diagnostic imaging , Child , DNA Primers/genetics , Female , Humans , Kearns-Sayre Syndrome/pathology , Likelihood Functions , Mexico , Models, Genetic , Molecular Sequence Data , Repetitive Sequences, Nucleic Acid/genetics , Sequence Alignment , Sequence Analysis, DNA , Tomography, X-Ray ComputedABSTRACT
Comparar las alteraciones neurológicas y psicológicas en niños con leucemia linfoblástica aguda (LLA), quienes habían estado con más de tres años sin tratamiento antineoplásico, y que recibieron profilaxis al sistema nervioso central (SNC) con base a radioterapia (RT), más quimioterapia intratecal (QTT) con metotrexate (Grupo 1) o sólo con QTIT (Grupo 2). En ambos grupos se realizó evaluación neurológica, electroencefalograma (EEG) y tomografía computada de cráneo (TACC). La evaluación psicológica consistió en la medición del coeficiente intelectual y de la función visomotora con la prueba de Bender. Las personas que realizaron cada una de las evaluaciones desconocían a que grupo de pacientes correspondía. Análisis estadístico: prueba exacta de Fisher y U de Mann-Whitnney. Catorce pacientes del grupo 1 y ocho pacientes del grupo 2. En el grupo 1 se encontró coeficiente intelectual significativamente inferior (mediana 83.5) al del segundo (90.5). En un paciente de cada grupo se encontraron alteraciones neurológicas, alteraciones en el EEG en 6 del grupo 1 y en 4 del grupo 2 y en la TACC, sólo en 2 pacientes del segundo grupo, sin tener diferencia estadística. Los niños con LLA quienes recibieron profilaxis al SNC con RT más QTIT, tuvieron mayor alteración en el rendimiento intelectual, en comparación con los tratados con metotrexate intratecal. En los dos grupos se presentaron anormalidades neurológicas, sin diferencia entre uno y otro grupo
