New study suggests that people diagnosed with chronic Lyme disease may actually have chronic fatigue syndrome.

A study published by researchers at the University of British Columbia compared a group of 13 patients with what they defined as alternatively diagnosed chronic Lyme syndrome (ADCLS) diagnosed by alternative laboratory methods with three other groups, 25 with chronic fatigue syndrome, 11 with systemic lupus erythematosus and 25 healthy controls. 

Subjects in each group were examined by history and physical examination, screening laboratory tests, seven functional scales, reference serology for Lyme disease using CDC criteria, reference serology for other tick-associated pathogens, and cytokine expression studies.

The ADCLS group were people who had had the diagnosis of Lyme disease made by laboratories using methods other than those recommended by the American Centre for Disease Control. It is relevant that all people who have had a diagnosis of Lyme disease contracted in Australia have had their testing done by laboratories using methods other than those recommended by the CDC and State Health Authorities in Australia. No cases of transmission of Lyme disease in Australia have ever been identified by CDC-approved testing.

All the patients with diagnoses of ADCLS and CFS were suffering from significantly disabling symptoms including inability to work full-time, sleep disturbance, and profound fatigue, and both these groups had significant differences compared with controls. However, the subjects with a diagnosis of ADCLS did not differ significantly from subjects with a diagnosis of CFS cases in any of the measured parameters. This included CDC-approved Lyme disease testing where all of the patients with either ADCLS or CFS were negative. These two groups also did not differ in distribution of positive serology for other tick-transmitted pathogens or in cytokine expression.
The researchers concluded that; "Lyme disease diagnosed by alternative laboratory methods is indistinguishable from [CFS] by detailed clinical and laboratory evaluation." "Discordant tests for Lyme disease likely represent false positive results from an alternative lab in our low prevalence setting [in British Columbia]."

Limitations of the study include small sample size with low power to detect small between-group differences, recall bias inherent in case-control studies, possible selection bias, and low generalizability to higher prevalence areas for Lyme disease.
The researchers conclude that people with a diagnosis of chronic Lyme disease in low-prevalence areas should be carefully assessed as many of them will have chronic fatigue syndrome and the Lyme disease diagnosis is likely to be due to false-positive laboratory tests. 

Further reading:

Abstract from Clinical Infectious Diseases
US National Institute of Allergy and Infectious Diseases – Chronic Lyme Disease

See also on this site:
Lyme diseaseChronic fatigue syndrome



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