'Chronic' Lyme disease overdiagnosed according to original expert
'Chronic' Lyme disease, according to Dr. Allen Steere who first identified the spirochetal contagion caused by ticks in the town of Lyme, Connecticut, is a seductive but all too often misleading diagnosis that may prevent patients from finding the care that they need.As noted on NPR:
"Dr. Allen Steere was 33 years old when he made that discovery in 1975, after a Connecticut resident came to him with swollen joints, flu-like symptoms and pounding headaches that no doctors could diagnose.Since then, he’s been on what he’s called a “long journey” to research Lyme — in part, to debunk advocates, who he says too often claim that Lyme disease is chronic and should be treated with long-term use of antibiotics.Steere acknowledges that a small number of some Lyme disease cases are persistent, but he tells Here & Now’s Robin Young that he advocates against treating it with long courses of antibiotics."
Here is the brief interview:
Dr. Steere is principal investigator at the Center for Immunology and Inflammatory Diseases at Massachusetts General Hospital in Boston and head of the Massachusetts General Hospital Lyme Disease Program.His work at the Laboratory of Translational Research in Lyme Disease and Rheumatoid Arthritis specifically includes:
"Dr. Steere and his colleagues are focusing on studies of autoimmunity in human patients with antibiotic-refractory Lyme arthritis or rheumatoid arthritis. A small percentage of patients with Lyme arthritis have persistent proliferative synovitis for months or even several years after antibiotic treatment and apparent spirochetal killing...The goal is to identify autoantigens that play a pathogenetic role in these chronic inflammatory forms of arthritis. In addition, the Steere laboratory is studying immune reactants in the joint fluid and synovial tissue of these patients. These inflammatory mediators, including chemokines and cytokines, are being characterized and correlated with clinical findings in patients. The goal is to understand better the pathogenesis of these diseases and to identify responses that may be used as biomarkers of disease activity.In Lyme arthritis, the Steere laboratory is exploring spirochetal and host factors that lead to apparent tissue-specific, autoimmunty in the synovial tissue of patients with antibiotic-refractory arthritis. They are identifying subtypes of Borrelia burgdorferi in patients with Lyme arthritis and the characteristics of the immune response elicited by each type. In addition, they are determining HLA-DR alleles and single nucleotide polymorphisms in host immune response genes that are associated with antibiotic-refractory Lyme arthritis, as well as the functional characteristics of the immune response associated with each of these polymorphisms."
Clinical note: For patients having received an appropriate course of antibiotics for verified Lyme disease who present with various post-infection symptoms, clinicians should be on the alert for autoimmune complications that can so often occur following successful eradication of pathogens associated with numerous infections due to loss of immune tolerance and cross-reactivity with self-antigens.
Earlier posts on Lyme disease
- Lyme disease, neuropsychiatric symptoms and autoimmunity
- Confusion over Lyme disease diagnosis can result in inappropriate treatment
- Chronic Lyme disease can be an autoimmune condition.
Center for Disease Control and Prevention information on ticks