The Current State of Knowledge on Baggio–Yoshinari Syndrome (Brazilian Lyme Disease-like Illness):..., 2022, Yoshinari et al

Full title: The Current State of Knowledge on Baggio–Yoshinari Syndrome (Brazilian Lyme Disease-like Illness): Chronological Presentation of Historical and Scientific Events Observed over the Last 30 Years

Abstract

Baggio–Yoshinari Syndrome (BYS) is an emerging Brazilian tick-borne infectious disease that clinically mimics Lyme Disease (LD) present in the Northern Hemisphere. LD is caused by spirochetes belonging to the Borrelia burgdorferi sensu lato complex and transmitted by Ixodid ticks of complex Ixodes rticinus. On the contrary, BYS is transmitted by hard Ixodid ticks of the genera Amblyomma, Rhipicephalus and Dermacentor. In 1992, the first cases of BYS were described in patients that developed EM rash, flu-like symptoms and arthritis after tick bite episodes. Since these findings, research in BYS has been developing for more than 30 years and shows that its epidemiological, clinical and laboratorial features are different from LD. Borrelia burgdorferi was never isolated in Brazil. In addition, specific serologic tests have shown little positivity. Furthermore, peripheral blood analysis of patients using electron microscopy exhibited structures resembling spirochete-like microorganisms or the latent forms of spirochetes (L form or cell wall deficient bacteria).

For these reasons, Brazilian zoonosis was defined as an exotic and emerging Brazilian infectious disease, transmitted by ticks not belonging to the Ixodes ricinus complex, caused by latent spirochetes belonging to the B. burgdorferi sensu lato complex with atypical morphology. The Brazilian ecosystem, combined with its ticks and reservoir biodiversity, possibly contributed to the origin of this new zoonosis, which emerged as a result of the passage of B. burgdorferi through exotic vectors and reservoirs.

Open access, https://www.mdpi.com/2076-0817/11/8/889/htm

 

"It is common that BYS patients in Brazil, especially those who have not been treated with antibiotics or have undergone only a few days of treatment, can show, even months or years later, laboratory manifestations or multisystem symptoms compatible with autoimmune or chronic fatigue/myalgic encephalomyelitis symptoms (CFS/ME). This phase is known as the reactive stage of BYS, which is possibly triggered by immune activation in response to spirochetal antigens.

In the Northern Hemisphere, some patients treated for LD with antibiotics present non-specific symptoms such as fatigue, sleep disorders, arthralgia, myalgia, a decrease in memory, loss of concentration and speech problems which last for more than 6 months. This set of complex clinical manifestations is called Post-Treatment Lyme Disease Syndrome (PTLDS). The etiology is unclear, and this syndrome is still intractable.

There are similarities between PTLDS related to LD and reactive symptoms described in BYS, and both involvements are possibly linked to immunologic disorders induced by B. burgdorferi infection. In Brazil, manifestations similar to those reported in PTLDS are also observed, and due to similarity in symptoms with those reported in CFS/ME, we decided to adopt the term BYS reactive stage resembling CFS/ME instead of PTLDS. It is important to note that this reactive stage is observed mainly in untreated patients."


"7.1.4. Reactive Disease Expression Resembling CFS/ME

Symptoms related to chronic fatigue syndrome/myalgic encephalitis are commonly found in BYS patients, and therefore, these complaints are regarded as minor criteria for the diagnosis of Brazilian Borreliosis. In 2009, Bonoldi [70] reported the presence of CFS/ME symptoms in 38 out of 70 cases (54.3%), while in 2000, Mantovani [34] demonstrated the presence of the disease in 40 out of 68 (58.8%) patients."

 

Why is this math so difficult?

Is it a spirochete that causes disease? Is it a form of Borrelia?

We don't need a mainframe computer to perform the calculations.

Moreover, we've seen this silliness before in the US midwest with Masters Disease (STARI).

It's like some agencies cannot get out of their own way fast enough to deny any link to Bb, and then to minimize symptom severity.

 

Ikr?

Ok, I'm trying to read the entire study. First, they were mentored by Steere. Second, they test the Brazilian strain - whatever it is - against the North American G39/40 strain, using the Dearborne 2T algorythm. Not surprisingly, they had to modify that because they weren't getting good responses.

So they try to publish results that are not inline with CDC models and they are met with skepticism..I'm beginning to feel for these guys.

You are right @Hutan , these guys were trying to do the right thing. I fear they got pigeon-holed at the get-go, and spent too much time trying to fit a square peg into a round hole. South America is an entirely different ecosystem. Borrelia will have evolved differently there, both in terms of the spirochete and its vectors. Hell, Borrelia evolved differently in the US. There are like 300 various strains, each manifesting a different degree of virulence.

 

Such a coincidence!
last week I was talking to a fellow neurologist who , upon reviewing my symptoms, told me that I should have a blood test for BY syndrome.
I had never heard about this syndrome, so now it´s a good time to improve my knowledge.
It seems that ther is not a comercial lab test for this disease, one gets the test only in a university hospital, I´ll try to reach out to my old firends at the university to see if I can have this test done.

 

I think this is an important study, @Andy , @Hutan , @jpcv .

This study could be a banner study for ILADS. If I'm the CDC/IDSA, this study may make me more than a little nervous.

I don't know where to begin.

First, the authors don't pull punches in the study itself. The name of the disease, well maybe. But the study is a candid expose into what the causative agent of Lyme can do - that causative agent being Bbss.

The name of the disease in this study is Baggio-Yoshinari Syndrome (BYS). Why there is "syndrome" at the end is beyond me. I'm still exhausted for trying to read this full thing over several days. It's hard for me to read that much anymore.

The authors state the causative agent of BYS is Borrelia-Burgdorferi sunsu stricto - Bbss. Bbss is also the causative agent of Lyme disease.

So Lyme and BYS are caused by the same species of spirochete.

Here's where it gets interesting. All the things that ILADS says Bbss can do relative to morphology and symptoms, these authors demonstrate in BYS. Many of the stuff the IDSA/CDC kinda sweep under the rug or downplay or outright dismiss? These authors demonstrate are real and can be found in their patients.

Moreover, they show that ixodes ticks are NOT the sole vectors of Bb variants.

AND, they demonstrate that Bbss can go latent, and then reactivate months or years later.. They actually reference tertiary phase, just like syphilis.

As for neurological involvement, here's just a snippet:
B. burgdorferi, the etiological agent of BYS, can remain dormant for long periods of time (cases # 2 and 6) and progress into the tertiary stage of the disease. This stage can be defined by a wide range of symptoms that develop after months or years after the initial Borrelia infection in a person who has not been treated with antibiotics. Diagnosis of late stage neuroborreliosis generally leads to little improvement even after antibiotic treatment since spirochetes may cause chronic structural derangements in the brain with irreversible damage to the central nervous system. Chronic encephalitis may be a consequence of infection caused by Borrelia burgdorferi; however, inflammation and injury in the brain may be a result of autoantibodies [77].

And this:
On the contrary, patients one, three, four, and five developed fast and progressive damage to the central nervous system soon after the acute stage of B. burgdorferi infection. Coincidentally, all four female patients, two of them young students, presented severe and unremitting psychiatric involvement, which did not respond to antibiotic treatment. The clinical analysis of each case suggests that the patients suffered a form of acute and severe encephalitis, which became progressively chronic and irreversible. Infection-induced autoimmunity, triggered by B. burgdorferi, was also taken into account as a possible cofactor which may lead to worsening and persistent brain damage. Furthermore, many of the severe and ongoing disabilities reported by patient five could be related to symptoms of chronic fatigue syndrome, which are also a consequence of Borrelia infection, according to our research.

There's so much more. They even have what amounts to as a sort of ME/CFS manifestation that they characterize as a reactive disease expression. But it's all down to a spirochete. This is to me a re-branded form of Lyme that validates most points ILADS has been trying to make for years. It may be a spirochete that is somewhat different than its northern cousins, but according to this study, once you get beyond the abstract, it's Bbss.

 

Hi, I got a positive response from the university lab, I´ll collect the blood sample and send them.