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Chronic Lyme Disease

Testing for chronic Lyme disease (chronic borreliosis) involves testing for the presence of specific IgG and IgM antibodies against the responsible bacterium of the genus Borrelia, using the Western blot technique.

What is Lyme Disease?

Lyme disease is one of the most common tick-borne zoonoses worldwide. It is caused by a spirochete (helically coiled bacterium) called Borrelia burgdorferi sensu stricto as well as Borrelia afzelii and Borrelia garinii.

Lyme disease occurs in two forms. Acute and chronic Lyme disease. The acute or early form is characterized by flu-like symptoms such as fever, muscle aches, headache, and fatigue. Some patients may develop a pronounced rash (migratory), which looks like a target (concentric circles). A rash can occur in 30-80% of cases. Most of the time, however, the rash is not a characteristic but a common redness of the skin. The rash starts a few days or even several weeks after the bite and then spreads over a period of days or weeks. Diagnostic tests may not be helpful in the early stages of the disease, often giving false-negative results. Treatment should not be delayed if Lyme disease is suspected (exposure, tick bite, presence of a characteristic rash).

If early Lyme disease is not diagnosed and treated early, spirochetes can spread and can "hide" in various parts of the body. Weeks, months, or even years later, patients may experience problems with the brain and nervous system, muscles and joints, heart and circulatory system, gastrointestinal tract, reproductive system, and skin. This condition is characterized as chronic Lyme disease.

Chronic Lyme disease has symptoms that mimic many other diseases. It can affect any organ in the body, including the brain and nervous system, muscles, joints, and heart. Patients with chronic Lyme disease are often misdiagnosed with chronic fatigue syndrome, fibromyalgia, multiple sclerosis, and various psychiatric illnesses, including depression. Misdiagnosis can delay proper diagnosis and treatment as the underlying infection progresses without control.

What are the most common symptoms of Chronic Lyme Disease?
 
  • Fatigue
  • Arthralgias
  • Myalgias
  • Sleep problems
  • Decline of mental functions
  • Depression
  • Neuropathies
  • Headaches
  • Heart disease
Why do we use Western blot?

The most common diagnostic tests for Lyme disease are indirect. They measure the patient's antibody response to the microorganism and not the microorganism itself. The two most commonly used antibody tests are the ELISA test and the Western blot. Another test that can be used to diagnose Lyme disease is polymerase chain reaction (PCR), which selectively amplifies a portion of Borrelia DNA so that the microorganism itself can be detected (immediate method).

Although the methodology of ELISA and Western blot is somewhat complicated, the basic principle is simple: the specific antibodies that may be present in the patient's serum react with Borrelia antigens and bind very strongly to each other. A second "labeled" antibody then recognizes the first antibody and using various methods, we can measure this binding, thus recognizing the presence of specific antibodies.

Western blot has more specificity and sensitivity than ELISA, thus reducing the cases of false-negative and (mainly) false-positive results.

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