porphyric reactions in the treatment of chlamydial infections

[Guest guest]

This is from Wheldon's updates on his wife's progress.

I can relate to many of the reactions he describes including the diurnal patterns sometimes feel "cured" at night and like a piece of dirt all day), I also have/had the vertigo attacks with some treatments (also had some before treatment, though)

Nelly

http://www.davidwheldon.co.uk/updates.html#anchor53272

Otherwise, the porphyric reactions continue. I have seen these in a number of patients now; the symptoms typically come and go through the day. They are characterised by symmetrical but incomplete numbness and tingling in the extremities; slight weakness of the hands and feet; vestibular disturbance (vertigo on moving the head but not while the head is kept stationary) and a rushing sound in the ears, often with a low-frequency component. Although they sound alarming they are not really troublesome. The numbness is more apparent than real; the sense of touch is hardly impaired. It is important to emphasize that these symptoms represent non-central neuropathy, and thus have nothing to do with MS. They may also be experienced by patients with non-CNS active persistent infections with Chl pneumoniae even before treatment begins, and tend to worsen as the disease is treated and the organisms killed. Often there is a 'flu-like component to these reactions.

still has the minor peripheral neuropathy which seems to occur when a persistent infection with Chlamydia pneumoniae is treated, and which is due, in part, to haem-precursors being systemically liberated following programmed host-cell death. (Chlamydia pneumoniae hinders programmed host-cell death in chronic disease, and when it is killed there is massive restructuring 'housekeeping' of host tissues.) It has a diurnal pattern, growing worse during the day but vanishing during the night. It is often seen when treating patients with a serologically proven chronic Chlamydia pneumoniae infection; its intensity seems be proportional to the original bacterial load. It can also be seen in patients with very large-load infections before treatment has begun.

Both chronic intracellular infection and the continued release of bacterial debris during and after antibiotic treatment, may cause 'cytokine storms'. (Cytokines are intercellular messenger-molecules that operate in a complex cascade.) Heightened cytokine activity can feel like incipient influenza; (indeed, the symptoms of influenza have their origin in cytokine turbulence.)

Chronic intracellular infection can cause an imbalance in the cellular and humoral arms of the immune system, eliciting the latter (possibly by the release of bacterial proteins) which then suppresses the former. This leads not only to the inability of the immune system to resolve the infection, but also to an inappropriate response to other foreign proteins. The same process may give rise to allergy. Treatment of the infection seems to right this imbalance. This seems to have happened with . For many years insect-bites had caused her major discomfort; cat-flea and mosquito bites would cause huge fluid-filled blisters (4 cm or more in diameter) and would make her feel unwell for several days, even weeks. Since treatment began insect-bites have ceased to be a problem.