The Phenomenon of "Chronic Lyme Disease"

Medical topics with questions, information and discussion related to Lyme disease and other tick-borne diseases.
Henry
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The Phenomenon of "Chronic Lyme Disease"

Post by Henry » Tue 7 Aug 2012 14:37

Eur J Neurol. 2012 Aug;19(8):1128-35. doi: 10.1111/j.1468-1331.2012.03691.x. Epub 2012 Mar 15.
The phenomenon of 'chronic Lyme'; an observational study.
Ljøstad U, Mygland A.
Source

Department of Neurology, Sørlandet Hospital, Kristiansand, Norway Institute of Clinical Medicine, University of Bergen, Bergen, Norway Department of Habilitation, Sørlandet Hospital, Kristiansand, Norway.
Abstract

Purposes:  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.

© 2012 The Author(s). European Journal of Neurology © 2012 EFNS.

PMID:
22416947
[PubMed - in process]

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Re: The Phenomenon of "Chronic Lyme Disease"

Post by X-member » Tue 7 Aug 2012 17:39

I don't think that they use the definition "chronic Lyme Disease" (written with quotation marks) for "post-Lyme" in Norway.

Are they* maybe talking about chronic Lyme borreliosis?
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.
Some information from Norway:

"Disseminated and chronic Lyme borreliosis in Norway, 1995 – 2004"

http://www.eurosurveillance.org/ViewArt ... icleId=568

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Re: The Phenomenon of "Chronic Lyme Disease"

Post by X-member » Tue 7 Aug 2012 17:50

I was actually informed a couple of days ago (by a person from Scandinavia) that (when I write in this forum) I should use the definition chronic Lyme disease when I talk about chronic Lyme borreliosis. I was told (by this person) that this is exactly the same thing. I had to inform this person from Scandinavia, about all the problems I have had to make people understand what I say, and why I instead had to use the definition late Lyme disease (or late or chronic Lyme borreliosis) in this forum.
Last edited by X-member on Tue 7 Aug 2012 21:55, edited 1 time in total.

Henry
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Re: The Phenomenon of "Chronic Lyme Disease"

Post by Henry » Tue 7 Aug 2012 19:30

Carina: Enough of this quibbling about terminology. Would you please tell all of us -- in your own words-- what you mean by chronic Lyme disease and late Lyme disease. How do you distinguish one from the other. Do not burden us with "snips" from other people's publications. Just give us clear, concise definitions in your own words.

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Re: The Phenomenon of "Chronic Lyme Disease"

Post by X-member » Tue 7 Aug 2012 19:44

What did I say in my earlier post, Henry?

I said that I have been trying to talk about chronic Lyme borreliosis or late Lyme disease in this forum.

But you ask me:
Would you please tell all of us -- in your own words-- what you mean by chronic Lyme disease and late Lyme disease.
As you can see (with the question you ask me), you still don't understand what I have tried to talk about.

The definitions for late or chronic Lyme borreliosis can be found in EUCALB:s information.

The definition used in this forum for late Lyme disease can be found in this forum, posted by Martian.

Henry
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Re: The Phenomenon of "Chronic Lyme Disease"

Post by Henry » Tue 7 Aug 2012 20:11

Carina: I repeat -- in your own words-- how do YOU define chronic Lyme borreliosis and late Lyme disease!! Please enlighten us.

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Re: The Phenomenon of "Chronic Lyme Disease"

Post by X-member » Tue 7 Aug 2012 20:14

I will not answer your question, since I already have given you an answer, Henry.

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Re: The Phenomenon of "Chronic Lyme Disease"

Post by X-member » Tue 7 Aug 2012 20:20

What is your defintition of chronic Lyme disease, Henry?

Is it remaining symptoms after treatment for Lyme disease with no signs of an active, persistent Lyme infection (after treatment)?

"The phenomenon of ‘chronic Lyme’; an observational study"

http://www.lymeneteurope.org/forum/view ... 744#p27585

From the topic above (Relative Risk Blog):

...Patients were eligible if they suffered from symptoms suspected by themselves or their doctor to be caused by ongoing chronic Bb infection. Objective clinical or laboratory manifestations of Lyme disease were not mandatory. They became aware of the study by a small notice in two nationwide newspapers, or by information from others, and were recruited through referral from primary care, other hospitals, or self-referral. They were informed that we wanted to chart symptoms, laboratory results, quality of life, and coping strategies. The first 30 referred patients were included.

Patients without evidences of ongoing Bb infection were classified in three categories;

Category 1: Symptoms of unknown cause with presence of anti-Bb antibodies in
serum or CSF.
Category 2: Symptoms of unknown cause without anti-Bb antibodies.
Category 3: Symptoms considered to be caused by another well-defined illness, i.e.,
fulfilling diagnostic criteria for another illness.
So, are they talking about "chronic Lyme disease" or are they talking about chronic Lyme borreliosis?
Last edited by X-member on Tue 7 Aug 2012 20:25, edited 1 time in total.

Henry
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Re: The Phenomenon of "Chronic Lyme Disease"

Post by Henry » Tue 7 Aug 2012 20:25

I take it that you can't do it.

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Re: The Phenomenon of "Chronic Lyme Disease"

Post by X-member » Tue 7 Aug 2012 20:32

Henry:
I take it that you can't do it.
"LNE definitions of late and chronic Lyme disease"

http://www.lymeneteurope.org/forum/view ... =11&t=3866

A quote:

Martian:
Late Lyme disease = untreated (or "inappropriately" treated) later stage of Lyme disease.
EUCALB:

http://www.eucalb.com/


"Chronic, persistent infection (s)"

http://www.lymeneteurope.org/forum/view ... 849#p28654

From the topic above, posted by me, Carina post the following quotes (from Eucalb):

Late Lyme borreliosis.

This uncommon stage presents several years after the initial infection and may involve the joints (Lyme arthritis), skin (acrodermatitis chronica atrophicans) or, rarely, chronic neurological syndromes.
ACA (acrodermatitis):

....which is probably the most common manifestation of chronic Lyme borreliosis in Europe.

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