AlleInformasjon om flåttenBorreliose: UtbredelseBorreliose: Diagnostikk og behandlingTBE: UtbredelseTBE: Diagnostikk og behandling

The phenomenon of Cronic Lyme. An observational study

TittelThe phenomenon of Cronic Lyme. An observational study
ForfatterLjostad U, Mygland A
EmnerBorreliose, kronisk
Kommentar29 pasienter som mente de hadde kronisk borreliose ble undersøkt ved hjelp av laboratorietester, klinisk undersøkelse og spørreskjema. Ingen hadde funn som indikerte pågående Borrelia-infeksjon, men hvorvidt eksisterende diagnostiske kriterier kan benyttes for pasienter med langvarige plager er omdiskutert. Andre sykdommer eller rest-plager etter borreliose var trolig årsaken til en del av pasientene. Sammenlignet med friske, opplevde pasientene lavere helsemessig livskvalitet, mer fatigue og mer negative forventninger knyttet til sin sykdom.
SammendragPURPOSES: To chart clinical, laboratory, and psychometric profiles in patients who attribute their complaints to chronic Lyme disease. METHODS: We assessed the patients by clinical examination, laboratory tests, and questionnaires measuring fatigue, depression, anxiety, health-related quality of life, hypochondriasis, and illness perceptions. RESULTS: We found no evidence of ongoing Borrelia burgdorferi (Bb) infection in any of the 29 included patients using current diagnostic guidelines and an extended array of tests. Eight (28%) had other well-defined illnesses. Twenty-one (72%) had symptoms of unknown cause, of those six met the suggested criteria for post-Lyme disease syndrome. Fourteen (48%) had presence of anti-Bb antibodies. The patients had more fatigue and poorer health-related quality of life as compared to normative data, but were not more depressed, anxious, or hypochondriacal. Their beliefs about the illness were characterized by negative expectations. CONCLUSION: Our patients, who all attributed their symptoms to chronic Lyme disease, were heterogeneous. None had evidences of persistent Bb infection, but whether current diagnostic criteria are functional in patients with longstanding complaints is controversial. Other well-defined illnesses or sequelae from earlier Lyme disease were probable as main explanatory factor in some cases. The patients were not more depressed, anxious, or hypochondriacal than the normal population, but they had poorer health-related quality of life, more fatigue, and negative expectations about their illness.