PubMed HealthSearch

Biomedical subjects

L E Mertz

Publications and source records attributed to L E Mertz.

6 recordsLinked to original sources

Vasculitis associated with malignancy.

A large variety of vasculopathic syndromes are uncommonly associated with malignancies. Vasculitis is usually manifested by skin lesions and is generally associated with hematologic malignancies rather than solid tumors. Evidence of autoantibodies, immune complexes, and complement consumption is typically absent. Myelodysplastic syndromes can be confidently linked to vasculitis on the basis of recent literature. The temporal relationship of malignancy to vasculitis development is variable except that vasculitis generally follows the discovery of hairy cell leukemia and splenectomy. Vasculitis may occasionally be a complication of chemotherapy, radiation therapy, and bone marrow transplantation. Occasionally, malignant disorders may mimic vasculitic syndromes. The etiopathogenesis of vasculitis in patients with malignant disorders is unknown. The recent literature on vasculitis and malignancy addresses predominantly case reports and small patient cohorts and identifies clinical characteristics rather than pathogenic mechanisms.

Adult

Diagnosing Lyme disease: the contribution of serologic testing.

Lyme disease is a multisystem disorder caused by a tick-transmitted spirochete, Borrelia burgdorferi. The diagnosis is based on clinical findings in most patients, particularly those with erythema migrans or exposure to geographic locations endemic for the disease. Detection of a specific antibody to B. burgdorferi is a useful confirmatory test in many patients. In atypical cases, however, a positive test result can be pivotal for determining the diagnosis and can lead to institution of definitive treatment. Serologic testing should not be used indiscriminately to diagnose Lyme disease or as the sole basis for administration of antibiotic therapy.

Aged

Focal encephalitis in a young woman 6 years after the onset of Lyme disease: tertiary Lyme disease?

A 19-year-old woman had severe focal inflammatory encephalitis. Six years previously, she had had classic untreated Lyme disease characterized by erythema chronicum migrans, bilateral facial palsies, and lymphocytic meningitis. During her recent encephalitic illness, Lyme disease serologic tests were positive by indirect immunofluorescence microscopy, enzyme-linked immunosorbent assay, and western blot (immunoblot technique) testing. We hypothesize that the patient's focal inflammatory encephalitis was a result of a persistent spirochetal infection of the central nervous system.

Adolescent

Localized scleroderma (morphea) and antibody to Borrelia burgdorferi.

Enzyme-linked immunosorbent assay (ELISA) and immunofluorescence assay (IFA) were performed in 25 and 32 cases of morphea, respectively. The more sensitive and specific ELISA was positive in only 1 of 25 cases and the mean value was lower in cases of morphea than in controls. IFA showed minimally reactive titers in 6 (19%) of 32 cases. There were an additional six cases with borderline titers. These data indicate that there is no specific association between Borrelia burgdorferi infection and morphea but that patients with morphea tend to have circulating antibodies that are cross-reactive.

Antibodies, Bacterial