Lyme Deaths From Heart Inflammation Likely Worse Than We Thought

General or non-medical topics with information and discussion related to Lyme disease and other tick-borne diseases.
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RitaA
Posts: 2768
Joined: Thu 1 Jul 2010 8:33

Lyme Deaths From Heart Inflammation Likely Worse Than We Thought

Post by RitaA » Tue 8 Sep 2015 4:13

The following article covers much more than heart inflammation caused by Lyme disease:

http://www.forbes.com/sites/judystone/2 ... e-thought/
Sep 4, 2015 @ 7:00 AM

Lyme Deaths From Heart Inflammation Likely Worse Than We Thought

by Judy Stone
Snippets:
While an update reported that pathologists at tissue banks retrospectively reviewed reports for 20,000 specimens, finding no additional cases, no mention is made of how thorough the reviews were, nor whether special stains to detect Borrelia were used. Dr. Paul Mead, of the Division of Vector-Borne Diseases, CDC, thinks it unlikely that cases were missed, as there are characteristic histologic findings with Lyme carditis. Given how infrequently autopsies are done, and how limited or “defective” they are at times, I’ve little doubt that other cases are missed.
Implications

As I read more and speak with experts, I have more questions and actually feel more muddled at times.

Why don’t some people get better after treatment for Lyme? Is it due to “persister” forms of intracellular bacteria, or those hidden in “sanctuaries” within the body, as we’ve just seen with Ebola hiding in the eye and semen?

Is the problem of ongoing symptoms due to a coinfection with other organisms that are hard to detect or not routinely looked for?

Or is the problem due to an abnormal immune response, triggering an autoimmune illness. One example is the development of meat allergies from certain tick bites.

What is more clear is that the tests that we have for diagnosing Lyme are woefully inadequate and are doing our patients a great disservice.

We desperately need more funding for Lyme surveillance and research. I’ll have more on this dismal state in an upcoming post.

Further, we need to have a broader discussion and willingness to look at alternative explanations as to why many patients have ongoing symptoms after treatment for Lyme, and more inclusive membership on panels that make up treatment guidelines.

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ChronicLyme19
Posts: 564
Joined: Mon 11 Aug 2014 17:42
Location: NY, USA

Re: Lyme Deaths From Heart Inflammation Likely Worse Than We Thought

Post by ChronicLyme19 » Mon 21 Sep 2015 16:56

Does anyone know how they test for Lyme on autopsy? If they are just looking for spirochetes they may be missing many cases not looking for the other forms.
Half of what you are taught is incorrect, but which half? What if there's another half missing?

dlf
Posts: 294
Joined: Sun 7 Apr 2013 15:36

Re: Lyme Deaths From Heart Inflammation Likely Worse Than We Thought

Post by dlf » Mon 21 Sep 2015 17:27

@ ChronicLyme19

I remembered seeing this description when it came out. Beyond that I have no clue.......maybe Dr. MacDonald could provide more.

Three Sudden Cardiac Deaths Associated with Lyme Carditis — United States, November 2012–July 2013
Weekly
December 13, 2013 / 62(49);993-996

http://www.cdc.gov/mmwr/preview/mmwrhtm ... mm6249a1_w

Patient 1
The heart was sent to tissue bank A for valve recovery. Microscopic examination of cardiac tissue found extensive myocarditis with mixed perivascular lymphoplasmacytic inflammation suggestive of Lyme carditis. A postmortem serum sample tested at CDC yielded serologic evidence of recent infection with B. burgdorferi, reacting strongly in both whole cell sonicate (WCS) and C6 enzyme immunoassay (EIA), and against all three scored bands (23 kDa, 39 kDa, and 41 kDa) by immunoglobulin M (IgM) Western blot. Western blot testing for immunoglobulin G (IgG) antibodies demonstrated reactivity against four of 10 scored bands (23 kDa, 39 kDa, 41 kDa, and 45 kDa); these serologic findings were consistent with early disseminated Lyme disease.
Histopathologic evaluation of postmortem tissues at CDC also was suggestive of Lyme pancarditis (Figure 1) and abundant spirochetes were observed by Warthin-Starry silver stain (Figure 2). Spirochetes also were detected in the myocardium by immunohistochemistry (IHC). Polymerase chain reaction (PCR) assays detected B. burgdorferi in extracts of formalin-fixed, paraffin-embedded heart tissue based on outer surface protein A, flagellin, and plasminogen-binding protein gene targets. No donor tissues were transplanted.
Patient 2
Examination of cardiac tissue at tissue bank A revealed moderate diffuse, perivascular lymphoplasmacytic pancarditis, similar to that seen in patient 1. Serologic testing at CDC was consistent with recent infection with B. burgdorferi; WCS and C6 EIAs were strongly reactive, IgM Western blot demonstrated strong reactivity to all three scored bands, and IgG Western blot demonstrated reactivity to four scored bands (23 kDa, 41 kDa, 58 kDa, and 66 kDa). Rare spirochetes were identified in cardiac tissue by Warthin-Starry silver stain and IHC; heart tissues tested positive for B. burgdorferi by PCR.
Patient 3
Examination of heart tissues at CDC again demonstrated diffuse mixed perivascular lymphoplasmacytic pancarditis. Warthin-Starry stain revealed spirochetes in the myocardium, and IHC and PCR assays confirmed the spirochete as B. burgdorferi. WCS and C6 EIAs were positive, IgM Western blot was positive for all three scored bands, and IgG Western blot demonstrated reactivity to one scored band (41 kDa).
An article came out in Medscape about the same time as the above.

Medscape Medical News
Sudden Cardiac Death in Untreated Lyme Carditis
Janis C. Kelly
| December 12, 2013

http://www.medscape.com/viewarticle/817736#vp_2

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