![]() (10)ĭespite the lack of evidence, many patients continue to get long term antibiotic treatment for symptoms attributed to CLD at a significant cost: financial and morbidity. (9) A CCDP Lyme Testing Fact Sheet is available for clinicians containing more information on which tests to watch out for: view. (7) The FDA is also concerned with the number of false positives for Lyme disease from commercial labs. Given the low prevalence of Lyme disease in BC, it is estimated that false-positive diagnoses from a commercial laboratory can exceed true positives by a ratio of at least 50 to 1. Most have a positive Lyme test by an independent lab offering a non-validated Lyme diagnostic test in the USA. These patients are negative for Lyme serology by reference lab testing. (9) Therefore, the vast majority of patients with symptoms attributed CLD in BC do not have PTLS. (8)īorrelia burgdorferi (the Lyme bacterium) is found in only 1 in 200 ticks in southern BC. Furthermore, the Mayo Clinic also considers CLD a CSS. Patient who come in with the label CLD almost invariable fulfill diagnostic criteria for CFS or fibromyalgia (FM). (7) This has also been my experience at the CCDP. David Patrick and the Complex Chronic Diseases Program (CCDP), found that patients with symptoms attributed CLD could not be distinguished from patients with CFS. ![]() (5) Some authors believe, like I do, that Post-Treatment Lyme Syndrome is a CSS. Readers might remember this constellation of symptoms from two prior TCMP I did: one on Central Sensitivity Syndromes (CSS) (4) and the other on Chronic Fatigue Syndrome (CFS). The symptoms include the constellation of fatigue, pain, sleep disturbance, and unexplained symptoms. ![]() Patients have persistent non-specific symptoms after adequate antibiotic treatment. Post-Treatment Lyme Syndrome is a distinct syndrome seen in patients with documented Lyme disease. (2) The Medical Post covered the conference in a recent issue. As a result of patient advocacy and a private members bill in parliament, a conference to develop a federal framework on Lyme disease was held in Ottawa in May of 2016. Patient advocacy groups would beg to differ. They go on to say that the majority of patients diagnosed with “chronic Lyme disease” (quotes used by UpToDate) “have no evidence of having had Lyme disease.” burgdorferi is the cause of chronic subjective symptoms” attributed to Lyme disease and recommends against the use of antibiotics in this patient population. A search for CLD on UpToDate (1) leads to a section entitled “POST-LYME DISEASE SYNDROME AND CHRONIC LYME DISEASE.” UpToDate states that the “currently available evidence does not support the hypothesis that persistent infection with B. Mitigating Potential Bias: Recommendations are consistent with current practice patterns.Ĭhronic Lyme Disease (CLD) is not a widely accepted medical term. Arseneau is the Director of Program Planning and a clinician at the Complex Chronic Diseases Program (CCDP). Ric Arseneau ( biography and disclosures)ĭisclosure: Dr.
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