Review Posttreatment Lyme disease syndrome and myalgic encephalomyelitis/chronic fatigue syndrome: A systematic review & comparison of pathogenesis 2023 Bai

Abstract

Lyme disease is the most common vector-borne illness in the United States and has been causing significant morbidity since its discovery in 1977. It is well-documented that about 10% of patients properly treated with antibiotics never fully recover, but instead go on to develop a chronic illness dubbed, posttreatment Lyme disease syndrome (PTLDS) characterized by severe fatigue, cognitive slowing, chronic pain, and sleep difficulties.

This review includes 18 studies that detail the symptoms of patients with PTLDS and uses qualitative analysis to compare them to myalgic encephalitis/chronic fatigue syndrome (ME/CFS), a strikingly similar syndrome. In the majority of the PTLDS studies, at least four of the six major symptoms of ME/CFS were also noted, including substantial impairment in activity level and fatigue for more than 6 months, post-exertional malaise, and unrefreshing sleep. In one of the included PTLDS articles, 26 of the 29 ME/CFS symptoms were noted.

This study adds to the expanding literature on the post-active phase of infection syndromes, which suggests that chronic illnesses such as PTLDS and ME/CFS have similar pathogenesis despite different infectious origins.

Key points

• This systematic review uses qualitative analysis to compare posttreatment Lyme disease syndrome to myalgic encephalitis/chronic fatigue syndrome, both of which are post-active phases of infection syndromes.
  
  
• The result of this review suggests that chronic illnesses such as PTLDS and ME/CFS have similar pathogenesis despite different infectious origins.
  

Open access, https://onlinelibrary.wiley.com/doi/10.1002/cdt3.74

 

This appears to have been authored by two individuals from a psychiatry department at a university in New Jersey. Writing about disease pathogenesis.

Good grief.

 

This framing is so bizarre. Not everyone who contracts Lyme disease is properly treated, or treated at all. It's difficult to get any diagnosis in the first place, the signs aren't always obvious, and there is a lot of denial and strongly held beliefs that discourage proper diagnosis, let alone treatment. And yet it's always brushed aside as some minor issue, always focusing on the minority who do get treated, even though antibiotics are not expected to be 100% effective.

It's not especially different than with LC. It's assumed that either treatment or natural immunity must be 100% effective, and yet there is no reason to believe that. This is why the idea of viral persistence was dismissed from the start, and continues to be even though COVID keeps being found in organs all over the body.

There is something deeply wrong with how medical reasoning goes about thinking about immunity, how the only two possibilities with pathogens are either death or complete eradication. Even though this is obviously wrong. But the literal label for this illness is "post-treatment", just as post-viral was assumed to mean "the virus is gone, it cannot harm you anymore". And that's when the infection isn't dismissed entirely.

Otherwise this review is not all that bad, but it starts off very wrong. The overlap certainly suggests a common overlap, probably in innate immunity, but there's been zero progress on all counts because of long- and deeply-held assumptions.

 

" Due to these factors, patients who satisfy the criteria for PTLDS may have had negative experiences in the healthcare field and experienced discrepancies between symptom onset and diagnosis. This may affect data in patients who may exaggerate symptoms to obtain care "
Exaggerate symptoms?

Geez....this kind of logic floors me. You'll likely either get care because you satisfy CDC/FDA-approved testing, in which case you don't need to exaggerate, or you go to a doctor who is indifferent to CDC guidelines, in which case why would anyone need to exaggerate symptoms?

"Pro-inflammatory states and changes in metabolism are the foremost hypotheses to explain the pathophysiology of each illness."
Really?

I wish they had looked under the carpet a bit if only about PTLDS. It's a nice theory, this overlap thingee, on paper, but you need to know the pitfalls embedded in anything from Lymeworld. PTLDS, in particular, is snake pit.