Non-specific symptoms in adult patients referred to a Lyme centre.
OBJECTIVES: There is controversy whether non-specific symptoms can be related to previous Lyme borreliosis (LB). Positive serology can be considered a proxy for a previous or persistent infection with LB. We assessed non-specific symptoms and serology in patients suspected of LB referred to a Lyme centre.
METHODS: Included were adult patients who visited a Lyme centre between 2008 and 2014. Before medical consultation, serum samples were taken and questionnaires on non-specific symptoms completed. The prevalence of non-specific symptoms was calculated for patients with positive and negative IgG serology. Logistic regression was used to obtain odds ratios (ORs) with 95% confidence interval (CI) for an association between positive serology and non-specific symptoms.
RESULTS: Of 1439 included patients, 31.6% (455/1439) had positive serology. The most common non-specific symptoms were severe fatigue (61.4%, 883/1439), sleep disturbances (54.8%, 789/1439), and stiffness of neck/back (52.6%, 757/1439). The prevalence of severe fatigue was 53.0% (241/455) in patients with positive serology versus 65.2% (642/984) in patients with negative serology (OR 0.74; 95% CI 0.58-0.94). The prevalence of sleep disturbances was respectively 46.2% (210/455) versus 58.8% (579/984) (OR 0.73; 95% CI 0.58-0.93). The prevalence of stiffness of neck/back was respectively 47.7% (217/455) versus 54.9% (540/984) (OR 0.85; 95% CI 0.67-1.06).
CONCLUSIONS: In patients referred to a Lyme centre, non-specific symptoms did not occur more frequently in patients with positive serology compared to patients with negative serology. Hence, a questionnaire on non-specific symptoms cannot be used for identifying patients with possible “post-Lyme borreliosis symptoms” in clinical practice.
I find it increasingly baffling how “positive serology” on a test that misses over half of all Lyme cases and is commonly known as being notoriously abysmal is still being used for research purposes. Move on people! This test is worthless!
I feel sorry for the sad-suckers who didn’t get a positive. They were sent home empty-handed to continue suffering in silence. Notice that MORE of the people testing negative had a considerably higher preponderance of symptoms…..
The sickest patients sometimes NEVER test positive.
Also, notice the symptoms….severe fatigue, sleep disturbances, and stiff back/neck. Those are notorious Lyme symptoms! In fact it screams Lyme (particularly the back/neck issue).
How about they treat these people clinically for Lyme and then retest? By giving a provoking agent, it would be interesting to see how many of these sero-negatives turn into positives.
I guess someone would have to use their God-given brain to do that….and we wouldn’t want to have to do that now would we?