Henry wrote: The whole thing -- including you and the "Great Wonk"-- is ludicrous. It's the kind of argument one makes when one doesn't really have any facts to support their delusional views. Lorraine Johnson advocates the use of alternative therapies that are not generally accepted by the medical community. Neither I nor the medical community would oppose the use of such therapies, provided there is unequivocal evidence to support their benefit and safety. Unfortunately, neither Johnson nor ILADS have ever provided ANY such evidence --none whatsoever. That's the real problem. It's evidence-based vs faith-based science.
The exact cause of PTLDS is not yet known. Most medical experts believe that the lingering symptoms are the result of residual damage to tissues and the immune system that occurred during the infection. Similar complications and "auto–immune" responses are known to occur following other infections, including Campylobacter (Guillain-Barre syndrome), Chlamydia (Reiter's syndrome), and Strep throat (rheumatic heart disease).
No one yet knows why Guillain-Barré — which is not contagious — strikes some people and not others. Nor does anyone know exactly what sets the disease in motion.
How is Guillain-Barré syndrome diagnosed?
Guillain-Barré is called a syndrome rather than a disease because it is not clear that a specific disease-causing agent is involved. A syndrome is a medical condition characterized by a collection of symptoms (what the patient feels) and signs (what a doctor can observe or measure). The signs and symptoms of the syndrome can be quite varied, so doctors may, on rare occasions, find it difficult to diagnose Guillain-Barré in its earliest stages.
Several disorders have symptoms similar to those found in Guillain-Barré, so doctors examine and question patients carefully before making a diagnosis.
https://www.rheumatology.org/Practice/C ... Arthritis/
How is Guillain-Barré treated?
There is no known cure for Guillain-Barré syndrome. However, there are therapies that lessen the severity of the illness and accelerate the recovery in most patients. There are also a number of ways to treat the complications of the disease.
Currently, plasma exchange (also called plasmapheresis) and high-dose immunoglobulin therapy are used. Both of them are equally effective, but immunoglobulin is easier to administer. Plasma exchange is a method by which whole blood is removed from the body and processed so that the red and white blood cells are separated from the plasma, or liquid portion of the blood. The blood cells are then returned to the patient without the plasma, which the body quickly replaces. Scientists still don't know exactly why plasma exchange works, but the technique seems to reduce the severity and duration of the Guillain-Barré episode. This may be because plasmapheresis can remove antibodies and other immune cell-derived factors that could contribute to nerve damage.
In high-dose immunoglobulin therapy, doctors give intravenous injections of the proteins that, in small quantities, the immune system uses naturally to attack invading organisms. Investigators have found that giving high doses of these immunoglobulins, derived from a pool of thousands of normal donors, to Guillain-Barré patients can lessen the immune attack on the nervous system. Investigators don't know why or how this works, although several hypotheses have been proposed.
The use of steroid hormones has also been tried as a way to reduce the severity of Guillain-Barré, but controlled clinical trials have demonstrated that this treatment not only is not effective but may even have a deleterious effect on the disease.
The most critical part of the treatment for this syndrome consists of keeping the patient's body functioning during recovery of the nervous system.
Rheumatic Heart Disease:
http://www.who.int/cardiovascular_disea ... trs923/en/
How is reactive arthritis diagnosed?
Diagnosis is largely based on symptoms of the inducing infections and appearance of typical musculoskeletal (joint and muscle) involvement. If indicated, doctors might order a test for Chlamydia infection or test for the HLA-B27 gene.
How is reactive arthritis treated?
The type of treatment depends on the stage of reactive arthritis.
Treatment for early stage.
The acute (early) inflammation can be treated with nonsteroidal anti-inflammatory drugs (often referred to as NSAIDs). These drugs, which suppress swelling and pain, include naproxen (Aleve), diclofenac (Voltaren), indomethacin (Indocin) or celecoxib (Celebrex). The exact effective dose varies from patient to patient.
The risk of side effects of these drugs, such as gastrointestinal (often called GI) bleeding, also varies. Your doctor will consider your risk of GI bleeding in suggesting an NSAID.
Treatment for late stage.
Chronic reactive arthritis may require treatment with a disease-modifying antirheumatic drug (sometimes called a DMARD) such as sulfasalazine or methotrexate. Sulfasalazine may be more useful when the reactive arthritis is triggered by a GI infection. In some cases, very inflamed joints may benefit from corticosteroid injections (cortisone shots).
New research suggests that a prolonged course of two or more antibiotics might be effective in patients with chronic Chlamydia-induced reactive arthritis.
Although the responsible pathogenic mechanism(s) still remain incompletely defined, methods for optimal prevention and management have changed during the past fifteen years.
Eradication of the pharyngeal streptococcal infection is mandatory
to avoid chronic repetitive exposure to streptococcal antigens
Ideally, two throat cultures should be performed before starting antibiotics. However, antibiotic therapy is warranted even if the throat cultures are negative. Antibiotic therapy does not alter the course,
frequency and severity of cardiac involvement
The eradication of pharyngeal streptococci should be followed by long-term secondary
prophylaxis to guard against recurrent pharyngeal streptococcal infections.
Your doctor may want to treat you in ways similar to patients who have fibromyalgia or chronic fatigue syndrome.
PTLDS is similar to Guillain-Barre, Rheumatic Heart Disease, and Reiter's Disease aka Reactive Arthritis, which are treated with plasma exchange, immunomodulators, prescription anti-inflammatories, chronic antibiotics, and patient responses to therapies are based upon clinical evaluation.
Whereas, PTLDS is treated as Fibromyalgia with antidepressants and gabapentin, neither of which have any presumed or evidenced effects upon the immune system, or infectious agents and their antigens. In the words of "Henry", there is no unequivocal evidence to support the benefit of antidepressants and gabapentin as sole treatments for PTLDS. None, whatsoever. That's the real problem.
Henry wrote: The whole thing -- including you and the "Great Wonk"-- is ludicrous. It's the kind of argument one makes when one doesn't really have any facts to support their delusional views.