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Interesting Article:"Chronic Lyme Disease"?

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[quote][i]Originally posted by la_kevin[/i]
[br]http://www.dentalplans.com/articles/26045/

Existence of "Chronic Lyme Disease" Questioned:

(HealthNewsDigest.com) - New Haven, Conn. - There is no evidence that "chronic Lyme disease" exists and if it does, the risks of prolonged antibiotic treatment outweigh any benefits, according to a review article by researchers at Yale and other institutions in the October 4 New England Journal of Medicine.

Lyme disease is the most common tick-borne infection in the Northern hemisphere. The disease is caused by bacteria, Borrelia burgdorferi (B. burgdorferi), and typically manifests as a rash, while later-less common-symptoms may include meningitis, facial nerve palsy and arthritis. All of these conditions typically respond well to conventional antibiotic treatment, but a minority of patients subsequently complain of fatigue, musculoskeletal pain, and difficulty with concentration or short-term memory. These symptoms are usually mild and self-limited and are referred to as "post-Lyme disease symptoms." If they last longer than six months, they are called "post-Lyme disease syndrome."

The review article, written by Eugene D. Shapiro, M.D., of Yale and colleagues from other institutions, focused on what the authors refer to as the "imprecisely defined" condition "chronic Lyme disease." The authors note that this term is used by a small number of physicians to describe patients they claim have persistent B. burgdorferi infection, a condition that they say requires long-term antibiotic treatment and may be incurable.

"Although 'chronic Lyme disease' clearly encompasses post-Lyme disease syndrome, it also includes a broad array of illnesses or symptom complexes for which there is no reproducible or convincing scientific evidence of any relationship to B. burgdorferi infection," said Shapiro, who is professor of pediatrics, epidemiology and public and investigative medicine at Yale School of Medicine.

The article advises clinicians to tell their patients that there is no scientific evidence of "chronic Lyme disease," and to inform patients of the risks of unnecessary antibiotic therapy. The authors say that patients should also be thoroughly evaluated for medical conditions that could explain the symptoms.

"Explaining that there is no medication, such as an antibiotic, to cure the condition is one of the most difficult aspects of caring for such patients," said Shapiro. "Failure to do so leaves the patient susceptible to those who would offer unproven and potentially dangerous therapies."

Shapiro and his colleagues maintain that "chronic Lyme disease" is a misnomer, and the use of prolonged, dangerous, and expensive antibiotic treatments is not warranted.

Other authors on the study included Henry M. Fender, Jr., M.D., Barbara J.B. Johnson, Susan O'Connell, M.D., Allen C. Steere, M.D., Gary P. Wormser, M.D. and the Ad Hoc International Lyme Disease Group.

Citation: N. Engl J Med, Vol. 357, No. 14 (October 4, 2007)

www.HealthNewsDigest.com

Read Original Article

� 2007 HealthnewsDigest.com

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la_kevin	Posted - 10/05/2007 : 04:21:13 http://www.dentalplans.com/articles/26045/ Existence of "Chronic Lyme Disease" Questioned: (HealthNewsDigest.com) - New Haven, Conn. - There is no evidence that "chronic Lyme disease" exists and if it does, the risks of prolonged antibiotic treatment outweigh any benefits, according to a review article by researchers at Yale and other institutions in the October 4 New England Journal of Medicine. Lyme disease is the most common tick-borne infection in the Northern hemisphere. The disease is caused by bacteria, Borrelia burgdorferi (B. burgdorferi), and typically manifests as a rash, while later-less common-symptoms may include meningitis, facial nerve palsy and arthritis. All of these conditions typically respond well to conventional antibiotic treatment, but a minority of patients subsequently complain of fatigue, musculoskeletal pain, and difficulty with concentration or short-term memory. These symptoms are usually mild and self-limited and are referred to as "post-Lyme disease symptoms." If they last longer than six months, they are called "post-Lyme disease syndrome." The review article, written by Eugene D. Shapiro, M.D., of Yale and colleagues from other institutions, focused on what the authors refer to as the "imprecisely defined" condition "chronic Lyme disease." The authors note that this term is used by a small number of physicians to describe patients they claim have persistent B. burgdorferi infection, a condition that they say requires long-term antibiotic treatment and may be incurable. "Although 'chronic Lyme disease' clearly encompasses post-Lyme disease syndrome, it also includes a broad array of illnesses or symptom complexes for which there is no reproducible or convincing scientific evidence of any relationship to B. burgdorferi infection," said Shapiro, who is professor of pediatrics, epidemiology and public and investigative medicine at Yale School of Medicine. The article advises clinicians to tell their patients that there is no scientific evidence of "chronic Lyme disease," and to inform patients of the risks of unnecessary antibiotic therapy. The authors say that patients should also be thoroughly evaluated for medical conditions that could explain the symptoms. "Explaining that there is no medication, such as an antibiotic, to cure the condition is one of the most difficult aspects of caring for such patients," said Shapiro. "Failure to do so leaves the patient susceptible to those who would offer unproven and potentially dangerous therapies." Shapiro and his colleagues maintain that "chronic Lyme disease" is a misnomer, and the use of prolonged, dangerous, and expensive antibiotic treatments is not warranted. Other authors on the study included Henry M. Fender, Jr., M.D., Barbara J.B. Johnson, Susan O'Connell, M.D., Allen C. Steere, M.D., Gary P. Wormser, M.D. and the Ad Hoc International Lyme Disease Group. Citation: N. Engl J Med, Vol. 357, No. 14 (October 4, 2007) www.HealthNewsDigest.com Read Original Article � 2007 HealthnewsDigest.com
3 L A T E S T R E P L I E S (Newest First)
lidge	Posted - 10/08/2007 : 14:09:27 Is it typical that TMS sufferers are often diagnosed with Chronic Lyme because they don't get better with the typical therapies? Of course I was given this diagnosis- guess by who? A shrink! When he saw the severe degenerative disease (I went to him because I was (and am!) depressed and anxious over my physical state -he thought it was a chronic low grade infection (probably Lyme). He sent me to a lyme specialist who did blood work. Only ELISA was elevated, not Westergren which is the confirmatory test. To be "safe" primary put me on a few months of antibiotics. When I told him not a bit better in any way, he thought I should go to Mayo clinic. Littlebird- one doc told me fibroymalgia too. I could go on and on. LaKevin - did you post this because Chronic Lyme has become the diagnosis "du jour" for alot of people on this forum? If so, maybe I am in the right place.
shawnsmith	Posted - 10/08/2007 : 07:45:31 From Dr. Sarno's MindBody Prescription Lyme Disease Although it differs considerably from those already discussed, another medical condition warrants mention. In this case we have a bona fide disease process to which a variety of physical symptoms are mistakenly attributed. Lyme disease is a bacterial infection acquired through the bite of a tiny tick that can manifest itself in neurological and arthritic symptoms. If someone has pain that cannot be explained by any of the usual diagnoses and has immunologic evidence (from a blood test) of having been infected, the symptoms will be attributed to Lyme disease. Whenever a foreign substance like a bacterium enters enters the body, the immune system activates protective measures. One of these is the creation of substances called antibodies that link up with the bacteria and neutralize them. Antibodies are specific for each bacterium; each of us has many different antibodies circulating in our blood. The amount of a specific antibody can be measured in the laboratory. The amount is known as an antibody titer. By this test one can determine whether or not an antibody for a specific disease is present in the blood, and how much. I have seen many people with TMS whose pain was attributed to Lyme disease because they had antibodies for the Lyme bacterium in their blood. One of many cases I encountered was a man I saw with severe TMS who did not accept that diagnosis and was later found to have antibodies for Lyme disease. He sued the neurologists who had attended him originally for malpractice, claiming that they had failed to test for Lyme antibodies. His symptoms were blatantly TMS, but in the absence of medical acceptance of TMS the neurologists found it difficult to defend themselves. ******* Sarno-ize it! Read chapter 4 of Dr. Sarno's "The Divided Mind." Also chapers 3, 4 and 5 in Dr. Scott Brady's "Pain Free For Life" are very important.
Littlebird	Posted - 10/08/2007 : 01:12:35 The article you posted and the other article on the topic at the link you provided were both interesting. Here's a link to the original article as it appeared in the NEJM. (It's one of their free access articles.) http://content.nejm.org/cgi/content/full/357/14/1422?query=TOC I was on a similar path as some of the patients who are told they have "Chronic Lyme Disease" with my diagnosis of Fibromyalgia--constantly searching for some medical treatment that would make me feel better. I'm really grateful that I'm not caught up in that search anymore, now that I know the real source of my symptoms.

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