Shtokailo K. Clinical, epidemiological and immunological features of Lyme borreliosis in combination with localized scleroderma, optimization of diagnosis and therapy

This dissertation is devoted to the optimization of diagnosis and therapy of Lyme borreliosis (LB) in combination with localized scleroderma (LS), based on the clinical and epidemiological features of their course and the data of laboratory and instrumental methods of examination. The percentage of seropositive individuals for B. burgdorferi s. l. and B. miyamotoi simultaneously, among patients with LB, in combination with LS, using a two-step serological diagnostic scheme (ELISA and immunoblot). It was evaluated the informativeness of IIFT (BIOCHIP technology) for the detection of specific serum IgG to B. henselae in patients with LB in combination with LS. The effectiveness of the proposed scheme of complex treatment of LB in combination with LS, with the use of doxycycline hydrochloride, was evaluated according to the dynamics of general and local complaints, the degree of activity of lesions of localized scleroderma, according to the mLoSSI, and the levels of cytokines (IL-6 and IL-10) in the serum of patients. The clinical and epidemiological features of LB in combination with LS have been clarified – most patients were bitten by ticks mainly in the abdomen, the localization of scleroderma lesions coincided mainly with the places of tick bites, lesions were more often numerous, small in size, accompanied with itching. The etiological structure of LB in combination with LS and IBm, was established, due to the determination of specific serum IgG to B. afzelii, B. burgdorferi s. s. and B. garinii by immunoblot method. The concentration of serum immunoglobulins of classes A, M, G, E and the level of endogenous intoxication in patients with LB and LB combined with IBm were determined. The involvement of B. burgdorferi and B. miyamotoi in sensitization of the body was established by the content of IgE.