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Revision as of 02:20, 8 November 2007 by 207.155.135.230 (talk)(diff) ← Previous revision | Latest revision (diff) | Newer revision → (diff)Morgellons (also called Morgellons disease or Morgellons syndrome) is a name given in 2002 by biologist Mary Leitao to a condition characterized by a range of cutaneous (skin) symptoms. Persons who suffer from this unexplained systemic condition report crawling, biting, and stinging sensations; finding fibers on or under the skin; and persistent skin lesions (e.g. rashes or sores). In addition to skin manifestations, some also report fatigue, mental confusion, short term memory loss, joint pain, and changes in vision, lyme disease, agrobacterium, chlamydia pneumoniae, and parasitic infection. It is not known at present whether the condition represents a new disease entity, or whether persons who identify themselves as having Morgellons have a common cause for their symptoms, share common risk factors, or are contagious. A majority of health professionals, including most dermatologists, regard Morgellons as a manifestation of other known medical conditions, including delusional parasitosis. The Morgellons Research Foundation, a non-profit advocacy organization, believes that it is a new infectious disease that will be confirmed by future research. "Other health professionals don't acknowledge Morgellons disease or are reserving judgment until more is known about the condition." Institutional Review Board approval for a CDC investigation into Morgellons is scheduled for October, 30 2007.
CDC investigation
A Centers for Disease Control and Prevention task force first met in June 2006 in order to develop a case definition of Morgellons. As of August, the task force consisted of 12 people, including two pathologists, a toxicologist, an ethicist, a mental health expert and specialists in infectious, parasitic, environmental and chronic diseases. In July of 2006, Dan Rutz, MPH, a communications specialist for the CDC, said "We're not ready to concede there's a new disease, but the volume of concern has stepped up because a lot of people are writing or calling their congressmen about it because they're frustrated that there's been no organized way to deal with their suffering." In May, 2007, KGW-TV Newschannel 8's Laural Porter asked Rutz "Do you have any idea what the fibers are?" Rutz said, "None. We don't know. We haven't studied them in a lab yet. There is nothing to imply there is , but our mind is open to everything, including that remote possibility."
In June 2007, the CDC opened a website on "Unexplained Dermopathy (aka "Morgellons")", stating, "CDC is working with public health and other medical professionals to identify potential sites for the epidemiologic investigation. CDC also is working with task force members to develop a scientific protocol, including an initial screening case definition for the epidemiologic investigation."
On August 1, 2007, the CDC issued a formal Request for Quotations for an epidemiologic investigation of Morgellons. The CDC plans to identify a database of potential cases (study cohort) by November 30, 2007.
Symptoms and diagnosis
There is currently no list of symptoms or differential diagnosis for Morgellons that is generally accepted by the medical community. Patients usually self-diagnose based on media reports and information published by the Morgellons Research Foundation. Symptoms usually include:
- Disturbing sensations of insect-like crawling, stinging or biting on or under the skin
- Skin rashes and lesions that do not heal
- Fiber-like filaments, granules or crystals that appear on or under the skin or that can be extracted from lesions
- Joint, muscle and connective tissue pain, including fibromyalgia
- Debilitating fatigue
- Cognitive dysfunction, including difficulty with concentration, short-term memory, and attention
Dr. William T. Harvey, director of the MRF medical advisory board, states that Morgellons patients also exhibit laboratory findings including increased levels of inflammatory cytokines, increased insulin, and antibodies to three bacterial pathogens. Many Morgellons patients have symptoms that are also consistent with Chronic Fatigue Syndrome, depression, obsessive-compulsive disorder, and attention deficit disorder. Dr. Rhonda Casey, chief of pediatrics at Oklahoma State University Hospital, while working with the OSU-CHS Center for the Investigation of Morgellons Disease, noted all her Morgellons patients looked ill with neurological symptoms, which included confusion, difficulty walking and controlling their foot (foot drop), and a sagging mouth when speaking; the OSU Center has issued a list of symptoms similar to that of the MRF.
The Morgellons Research Foundation has adopted a draft Case Definition developed by their Medical Advisory Board that is intended to be refined as new information is available.
Theories about the fibers
Randy Wymore, a former research director of the MRF and presently Director of the Oklahoma State University Center for Health Sciences' Center for the Investigation of Morgellons Disease, claims that Morgellons patients have masses of dark fibers visible at 60x magnification under the unbroken skin, while unaffected individuals do not. Wymore sent samples of fibers supplied by Morgellons patients to the Police Crime Lab in Tulsa, Oklahoma for analysis. After checking the fibers against known fibers in the FBI's national database, lab director Mark Boese said the fibers were "consistent with something that the body may be producing," adding, "These fibers cannot be manmade and do not come from a plant. This could be a byproduct of a biological organism."
Dr. Rhonda Casey, chief of pediatrics at Oklahoma State University Hospital and part of the MRF research team at OSU, reported that she has examined many patients' skin via a dermatoscope and performed biopsies on both lesions and apparently healthy skin, and that "she saw fibers embedded in both places. The white ones, she says, are hard to see. A dermatologist who either didn't look at all, or didn't use a dermatoscope, might not see them under the skin."
Bacterial hypothesis
Three members of the Morgellons Research Foundation, including Raphael Stricker, President of the International Lyme and Associated Diseases Society (ILADS), authored an article about Morgellons published by the American Journal of Clinical Dermatology in early 2006. The authors wrote that "Morgellons disease may be linked to an undefined infectious process," and reported that many patients with Morgellons disease have positive Western blots for Borrelia burgdorferi, the causative agent of Lyme disease, and treatment with anti-bacterials appropriate for Lyme disease leads to remission of Morgellons symptoms in most patients. Dr. Harvey has also stated there is serological evidence of bacterial pathogens in Morgellons patients. The underlying data for these claims have not been published and the findings have not been independently confirmed.
Dr. Stricker, along with Dr. Citovsky, MRF board member from the State University of New York at Stony Brook and an expert on plant pathogens, reported in January, 2007, that Morgellons skin fibers appear to contain cellulose. Five skin samples of Morgellons patients contained evidence of DNA from Agrobacterium, a plant-infecting organism which is known to produce cellulose fibers at infection sites within plant host tissues. Agrobacterium can be responsible for opportunistic infections in humans with weakened immune systems, but has not been shown to be a primary pathogen in otherwise healthy individuals.
Another MRF board member, Dr. Ahmed Kilani, the CEO of Clongen and a microbiologist with a Ph.D. from Stanford University Medical School, does not agree that Morgellons is a bacterial infection. Based on his own preliminary research, Kilani has hypothesized that Morgellons "is a more complex fungus, algae or a novel parasite. The fibers are most likely feeding structures as they have strong resemblance to aerial hyphae observed in many fungal species."
Treatment
People who say that they have Morgellons will frequently reject the diagnosis of delusional parasitosis and, "report that their symptoms are not taken seriously." There are medical practitioners that hypothesize Morgellons is an infectious process, including several associated with the MRF, who will listen to patient's symptoms, examine them, order laboratory tests, and treat Morgellons symptoms accordingly, including the use of antibiotics, antifungals, antiparasitic medications, herbal supplements, and light therapy. Physicians associated with the Morgellons Research Foundation have reported that some Morgellons patients who test positive for Lyme disease obtain symptom relief using aggressive, long-term antibiotic treatment for chronic Lyme disease. However, if the treatment is discontinued the symptoms return.
See also
References
- ^ Unexplained Dermopathy (aka "Morgellons") Centers For Disease Control, June 12, 2007
- ^ Savely VR, Leitao MM, and Stricker, RB. The mystery of Morgellons disease: infection or delusion? Am J Clin Dermatol. 2006;7(1):1–5 PMID 16489838
- ^ Mysterious 'Morgellons disease' prompts US investigation, Emma Marris, Nature Medicine, 30 August 2006
- Dunn J, Murphy MB, Fox KM. Diffuse Pruritic Lesions in a 37-Year-Old Man After Sleeping in an Abandoned Building. Am J Psychiatry 2007. 164:1166–1172. PMID 17671278 Full text link
- Morgellons Research Foundation web site
- "Morgellons disease: Managing a mysterious skin condition". Mayo Clinic. 2007-05-02. Retrieved 2007-08-04.
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- Itching for Answers to a Mystery Condition, TIME, July 28, 2006
- Savely G, Leitao MM. Skin lesions and crawling sensations: disease or delusion? Adv Nurse Pract. 2005 May;13(5):16–7. PMID 15898309
- ^ Harvey WT. Morgellons disease. J Am Acad Dermatol. 2007. 56(4):705–6. PMID 17367622 Full text link
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- "Morgellons Mystery". ABC News Primetime. Aug 9, 2006. Retrieved 2007-08-14.
- International Lyme and Associated Diseases Society (ILADS)
- Stricker RB, Savely VR, Zaltsman A, Citovsky V. Contribution of Agrobacterium to morgellons disease. J Invest Med. 2007. 55 (1): S123-S123 Suppl. S. (Abstract)
- Hulse M, Johnson S, Ferrieri P. Agrobacterium infections in humans: experience at one hospital and review. Clin Infect Dis. 1993 Jan;16(1):112–7. PMID 8448285
- Kilani, A. Investigation of Novel Organism Implicated in Morgellons Disease. Research proposal published on the [http://www.morgellons.org/clogen1.htm MRF web site.
- ^ Morgellons Disease Baffles Patients And Doctors By Benjamin Chertoff, Popular Mechanics, Published in the June 2005 issue
- Disease: Real or state of mind? By Melissa Healy, Los Angeles Times, 2006-11-13
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was invoked but never defined (see the help page). - Vital Signs: Bugs Are Crawling In My Skin, by Claire Panosian Dunavan, Discover, 2006-11-20