Turning a blind eye on Lyme disease

Medicine has made great strides in understanding diseases with lesions, such as cancer, heart disease, and strokes. But it has had a more difficult time understanding the many other syndromes, which lack any markers for organ lesions. Yet, these non-lesion diseases, like chronic fatigue syndrome or Lyme disease, are more prone to being misdiagnosed and leaving patients with debilitating symptoms.

“Our ignorance is often unbearable and may lead us to turn a blind eye on non-lesional diseases,” explains Raoult from the Aix-Marseille Université in France. [1] Such ignorance, Raoult says, has at times led scientists to believe that some diseases had a “psychiatric cause while they were somatic and could be easily treated.”

One could say that, in some cases, Lyme disease is one of those diseases. It often presents without lesions and can be easily dismissed by treating clinicians. This lack of knowledge surrounding Lyme disease has left some in the medical community to turn a blind eye on the disease and disregard its potential destructiveness.

In 1990, Logigian and colleagues described 27 patients with chronic neurologic Lyme disease who did not have typical lesions. Instead, they presented with severe symptoms, such as fatigue, sleep disturbance, poor concentration, irritability, sadness, headaches, lightheadedness, paresthesias, and joint pain. These symptoms lasted up to 14 years. [2] Other studies have also demonstrated chronic symptoms in Lyme disease patients. [3,4] The majority of these patients have seen multiple doctors before being correctly diagnosed.

Raoult’s editorial, “Of ignorance and blindness: the Lyme disease paradigm,” points out, “Patients consulting numerous physicians to obtain a therapeutic solution are truly sick.” However, “Some of them may obviously be phony patients, but they are usually rapidly identified.”

Unfortunately, there are doctors who deny the existence of chronic manifestations of Lyme disease. For these patients and others with non-lesional diseases, “this succession of consultations and physicians with the sole objective of feeling better is extremely grueling.” [1]

“And our blindness should not lead us to deny the existence of the disease itself,” Raoult states. In fact, “This denial is at the core of the rage of some patient advocacy groups.” [1]

[bctt tweet=”Turning a blind eye on Lyme disease patients. ” username=”DrDanielCameron”]

There are doctors, however, who reject this concept of ignorance and “ascribe such symptoms to existing diseases even though diagnostic examinations validated by healthcare authorities and scientific societies provide negative results for those existing diseases,” writes Raoult.  “One must admit that in some diagnostic fields the sensitivity of our tools is not 100%.”

“Scientists are and must remain sceptical, modest, and ready to change their mind in light of new data,” Raoult points out. “They must, however, be aware that they will never know everything.”

 

References:

  1. Raoult D. Of ignorance and blindness: The Lyme disease paradigm. Med Mal Infect. 2018.
  2. Logigian EL, Kaplan RF, Steere AC. Chronic neurologic manifestations of Lyme disease. N Engl J Med. 1990;323(21):1438-1444.
  3. Fallon BA, Keilp JG, Corbera KM, et al. A randomized, placebo-controlled trial of repeated IV antibiotic therapy for Lyme encephalopathy. Neurology. 2008;70(13):992-1003.
  4. Klempner MS, Hu LT, Evans J, et al. Two controlled trials of antibiotic treatment in patients with persistent symptoms and a history of Lyme disease. N Engl J Med. 2001;345(2):85-92.

3 Replies to "Turning a blind eye on Lyme disease"

  • KMM
    06/24/2018 (11:48 pm)
    Reply

    Dear Doctor,

    Would you please consult with me on the case of 22 yo woman who had positive serological studies at age three, based on a target lesion. She was given 3 weeks of oral amoxicillin at that time.

    She presents now as having extreme fatigue, chronic joint pain of the large joints e.g. hips, knees, shoulders; muscle pain with no exertion; hypersomnia,; intermittent sleep; with frequent awakenings, and palpitations.

    She has back pain and shoulder pain every day. She also has bilateral sharp knee pain, lasting for several minutes at a time, infrequently.
    Shoulder pain, is again, bilateral, and frequently she has neck pain as well.

    She has been treated for sleep apnea, but that diagnosis was made without a sleep study. Unsurprisingly, a CPAP machine in use for 3 months, yielded no benefit. An actual sleep study revealed no abnormalities. She is being treated for possible hypothyroidism, mild depression, and extreme anxiety. Her current meds are:

    Other medical issues are limited to seasonal allergies with sinus pain, She also has been diagnosed as having interstitial cystitis, frequent urination when not taking solifenacin 10mg/ daily.

    Propranolol LA 120 mg is given for anxiety and Propranolol 20 mg as needed for anxiety. However she only is prescribed this for anxiety, it is not given for her heart or blood pressure, but for her anxiety. She has no other cardiac issues at this time, excepting palpitations with a HR below 100 bpm.

    Solifenacin 10 mg/ daily
    Levocetrizine 10 mg/day rhinitis and sinus pain
    Singuair 10mg/daily for rhinitis and sinus pain
    Luvox CR 300 mg/daily for anxiety
    Vitamin D 5,000 IU supplement
    MVT

    She is trying to complete college at this time, and I am very concerned about her.

    Sincerely,
    KMM

  • Linda Olley, RN, Founder of Harrisburg Lyme
    06/19/2018 (1:28 am)
    Reply

    There exists mounting scientific evidence to the complexity of Lyme and other tick-borne diseases. These stealth pathogens altar our quality of life and activities of daily living. The emotional, physical, psycho-social and financial impact cannot possibly be fully understood except by the millions of people worldwide who suffer from these “invisible illnesses.”
    Thank you, Dr. Cameron for your continued strides to provide education, awareness and advocacy. In my opinion, Lyme is a health care disaster, and with the current research and evidence, no health care professional should be turning a blind eye! Shame on them!!!


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