Study: Early Lyme disease diagnosis difficult, treatment improvements needed

An early diagnosis of Lyme disease can help prevent systemic disease involvement, but currently available diagnostic tests are not sensitive, according to recently presented research. The findings also noted treatment regimens may not prevent long-term complications for many patients, and insurance coverage for treatment may be hindered by diagnostic and treatment shortcomings.

According to research from investigators at Drexel University College of Medicine, patients may present with erythema migrans in 60% to 80% of cases, and CDC-recommended ELISA and immunoblot staining may only confirm the presence of Lyme disease in 29% to 40% of cases. Long-term sequelae for 6 years may be present in 34% of patients, despite following a recommended course of treatment. Furthermore, Borrelial spirochetes may comprise up to 25% of the organisms in brains of patients with Alzheimer’s disease, and the presence of DNA of the organisms has been confirmed in the synovial tissues of patients with Lyme disease-associated arthritis. Skin cultures have a 49% sensitivity, while investigators noted polymerase chain reaction DNA tests for Borrelial and immunoglobulins have variable reliability.

Treatment with doxycycline has resulted in the persistence of organisms in some individuals, and the development of vaccines has been limited due to false signaling produced by the organisms. The persistence of the organisms may be related to biofilms present in arthritic joints. Long-term complications may affect the heart, skin, joints, nervous system and eyes. – by Shirley Pulawski

Reference:

Allen H, et al. Paper #3273. Presented at: American Academy of Dermatology 74th Annual Meeting; March 4-8, 2016; Washington, D.C.

Disclosure: The researchers report no relevant financial disclosures.