Clare L. Cherney, MD
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Cherney CL. Overdiagnosis of Lyme Disease. Ann Intern Med. 1998;129:752. doi: 10.7326/0003-4819-129-9-199811010-00031
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Published: Ann Intern Med. 1998;129(9):752.
TO THE EDITOR:
After reading Reid and colleagues' report , I came away with a feeling of “Enough already!”
The authors' stated objective was to identify the complications of patients who had been inappropriately diagnosed and treated for Lyme disease. Did any of the authors also evaluate patients in the Yale University Lyme Disease Clinic during the study? The stated objective would certainly affect the physicians' objectivity in evaluating patients' Lyme disease status.
What data show that continued antibiotic therapy does not help with the fatigue-arthralgia-myalgia syndrome? In my review of the literature, the only prospective study evaluating patients with post-Lyme disease fibromyalgia-like syndromes and their response to appropriate courses of antibiotics for Lyme disease was an observational study involving 15 participants . An intriguing finding was that 10 of 14 (71%) of their patients who received antibiotics responded and then relapsed after antibiotic therapy was stopped. Why was this interpreted as an antibiotic failure or simply a placebo effect? Perhaps these patients did not receive the right amount of the right antibiotic. In a recently published study, albeit a retrospective and observational one, patients with similar fibromyalgia-type symptoms after Lyme disease seemed to be helped by prolonged tetracycline therapy (1 to 11 months) . Obviously, there is a lack of randomized, controlled trials of antibiotics for fibromyalgia-like syndromes complicating Lyme disease.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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