Chronic Lyme disease ???
August 16, 2014 | 15,00 EUR | answered by Dr. med. Ive Dr. Schaaf
Lyme disease? Well, due to persistent symptoms, I had extensive laboratory tests done, including many virus tests etc. The borrelia burgdorferi AK IgM 39 kd BmpA value was positive. The LTT for Borrelia was also positive now... (but I haven't received detailed results yet). According to the laboratory doctor, this test is also not really 100% reliable. My symptoms (mainly neurological such as muscle cramps, tremors, stabbing pains, etc.) have already been examined neurologically, without any findings. Cerebrospinal fluid was also drawn last year, with no findings except for a slight disruption of the blood-brain barrier with slightly elevated protein levels... I urgently need advice on what to do. Should I see a rheumatologist? Or what exactly should I do? Thank you.
Good day,
the increased IgM indicates that there has been an encounter with the Borrelia pathogen and it is still ongoing. Your symptoms could well be triggered by this pathogen.
Regarding Lyme disease, there are two camps worldwide: Some believe that it could always be Lyme disease and treat generously with antibiotics. Others say that chronic Lyme disease is extremely rare and recommend further investigation without immediate treatment.
I assume your general practitioner has conducted the diagnostics. Lyme disease is definitely "on the table" and if you wish, an antibiotic treatment could be carried out now, for example 2 x 200 mg of Doxycycline per day for 3-4 weeks. You should discuss this with your doctor, who will then prescribe the antibiotic. If your symptoms improve or (I hope for you) disappear and the follow-up lab test shows a normal IgM, then there is a lot to suggest you have or hopefully had Lyme disease.
I hope this wasn't too confusing, but I wanted to prepare you for the fact that you may encounter different recommendations. My tip for a pragmatic approach: Start antibiotic treatment as described above (for normal weight adults) and continue to monitor. With some luck, everything will be over soon, otherwise you will need to continue searching for another cause of your symptoms.
Kind regards,
Dr. Schaaf
