Post-treatment Lyme disease syndrome symptomatology and the impact on life functioning: is there something here?

Abstract

PurposeA subset of patients treated for Lyme disease report persistent or recurrent symptoms of unknown etiology named post-treatment Lyme disease syndrome (PTLDS). This study aims to describe a cohort of participants with early, untreated Lyme disease, and characterize post-treatment symptomatology and functional impact of PTLDS over time.MethodsSixty-three participants with erythema migrans and systemic symptoms were enrolled in a prospective cohort study. Participants underwent physical exams and clinical assessments, and completed the SF-36 (daily life functioning) and the Beck Depression Inventory, Second Edition (BDI-II) (depression), at each of five visits over a period of 6 months.ResultsSigns of Lyme disease disappeared post-treatment; however, new-onset patient-reported symptoms increased or plateaued over time. At 6 months, 36% of patients reported new-onset fatigue, 20% widespread pain, and 45% neurocognitive difficulties. However, less than 10% reported greater than “minimal” depression across the entire period. Those with PTLDS (36%) did not differ significantly from those without with respect to demographics, pre-treatment SF-36, and BDI-II scores. Statistically significant differences were found over time on the Role Physical, Vitality, Social Functioning, Role Emotional, and Mental Health subscales (with a trend toward significance for the remaining three subscales of Physical Functioning, Bodily Pain, and General Health) of the SF-36 between those with an eventual PTLDS diagnosis and those without when measured at 6 months.ConclusionsUnlike clinical signs of Lyme disease, new-onset symptoms are reported by a subset of participants without evidence of depressive symptomatology. Patients who developed PTLDS had significantly lower life functioning compared to those without PTLDS. We propose future avenues for researching infection-triggered symptoms resulting from multiple mechanisms.

CCL19 as a Chemokine Risk Factor for Posttreatment Lyme Disease Syndrome: a Prospective Clinical Cohort Study

“…These posttreatment symptoms may be mild and limited or severe and chronic. When posttreatment symptoms last 6 months or longer and impair life functioning, patients meet the case definition for posttreatment Lyme disease syndrome (PTLDS) (1,13,14). Studies have suggested a severe initial illness (15,16), delayed treatment, neurologic involvement (1,17), or suboptimal antibiotic therapy (17,18) to be potential risk factors for development of PTLDS.…”

Correlates of Perceived Health-Related Quality of Life in Post-treatment Lyme Encephalopathy

“…19, 5, 2, 20 One study examined associations between clinical features that appear early in the illness and functional outcome in PTLDS patients, but did not examine the influence of prominent clinical variables that manifest after treatment. 21 Knowing the extent to which commonly reported symptoms such as cognitive impairment, pain, fatigue, or psychopathology contribute to functional impairment would enable more targeted therapies for patients with persistent symptoms, while further elucidating their specific nature and impact in PTLDS.…”

Хвороба Лайма У Дитячому Віці: Погляд На Проблему Та Клінічний Випадок

“…Стан дитини за-довільний, знаходиться під спостереженням, оскільки після перенесеного бореліозу можуть зберігатися асте-новегетативні реакції у вигляді порушення сну, гіпер-збудливості, емоційної лабільності. Даний стан оха-рактеризовано як Post-Lyme-Disease syndromes (PLDS) і за американськими та європейськими рекомендація-ми не потребує лікування, якщо раніше була проведена адекватна антибактеріальна терапія [29].…”