The full content of Annals is available to subscribers

Subscribe/Learn More  >
Articles |

Lyme Disease Associated with Fibromyalgia

Hal Dinerman, MD; and Allen C. Steere, MD
[+] Article, Author, and Disclosure Information

Grant Support: In part by grant AR-20358 from the National Institutes of Health and by the Eshe Fund.

Requests for Reprints: Hal Dinerman, MD, New England Medical Center, Box 406, 750 Washington Street, Boston, MA 02111.

Current Author Addresses: Drs. Dinerman and Steere: New England Medical Center, #406 750 Washington Street, Boston, MA 02111.

©1992 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1992;117(4):281-285. doi:10.7326/0003-4819-117-4-281
Text Size: A A A

Objective: To describe the clinical and laboratory findings as well as results of treatment in patients with Lyme disease associated with fibromyalgia. ▪Design: Observational cohort study. The mean duration of observation was 2.5 years (range, 1 to 4 years). ▪Setting: Diagnostic Lyme disease clinic in a university hospital. ▪Patients: Of 287 patients seen with Lyme disease during a 3.5-year period, 22 (8%) had fibromyalgia associated with this illness, and 15 (5%) participated in the observational study. ▪Measurements: Symptoms and signs of fibromyalgia, immunodiagnostic tests for Lyme disease, and tests of neurologic function. ▪Results: Of the 15 patients, 9 developed widespread musculoskeletal pain, tender points, dysesthesias, memory difficulties, and debilitating fatigue a mean duration of 1.7 months after early Lyme disease; the remaining six patients developed those symptoms during the course of Lyme arthritis. At the time of our evaluation, late in the course of their illness, 11 patients had positive immunoglobulin (lg) G antibody responses to Borrelia burgdorferi by enzyme-linked immunosorbent assay (ELISA), one had a positive Western blot, and the three seronegative patients had positive cellular immune responses to borrelial antigens. Four patients had abnormal cerebrospinal fluid analyses that showed an elevated protein level, a slight pleocytosis, or intrathecal antibody production to the spirochete. The signs of Lyme disease resolved with antibiotic therapy, usually intravenous ceftriaxone, 2 g/d for 2 to 4 weeks, except in one patient with persistent knee swelling. However, 14 of the 15 patients continued to have symptoms of fibromyalgia. Currently, only one patient is completely asymptomatic. ▪Conclusions: Lyme disease may trigger fibromyalgia, but antibiotics do not seem to be effective in the treatment of the fibromyalgia.





Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $42.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Related Point of Care
Topic Collections
PubMed Articles
Posttreatment Lyme disease syndrome. Infect Dis Clin North Am 2015;29(2):309-23.
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.