TY - JOUR
T1 - Development of a foundation for a case definition of post-treatment Lyme disease syndrome
AU - Aucott, John N.
AU - Crowder, Lauren A.
AU - Kortte, Kathleen B.
N1 - Funding Information:
The authors would like to thank Drs Melissa Fox and Isaac Yoon and the staff at Patient First for their support with this study. The authors would also like to thank the Lyme Disease Research Foundation for their financial support with this study.
PY - 2013/6
Y1 - 2013/6
N2 - Objectives: The study objective is to demonstrate the clinical and research utility of an operationalized definition of post-treatment Lyme disease syndrome (PTLDS), as proposed by the Infectious Diseases Society of America. Methods: Seventy-four patients with confirmed erythema migrans and 14 controls were enrolled. Patient-reported symptoms and health function (SF-36) were collected pre-treatment and at follow-up visits over 6 months post-treatment. Results: Eight (11%) patients met our operationalized definition of PTLDS, which included self-reported symptoms of fatigue, widespread musculoskeletal pain or cognitive complaints, and functional impact as measured by a T score of <45 on the composite SF-36. No controls met the functional impact criteria. Forty-three (60% patients returned to their previous health status when measured at 6 months post-treatment. Twenty (28%) patients had either residual symptoms or functional impact, but not both, and did not meet criteria for PTLDS. Conclusions: This operationalized definition of PTLDS allows for identification of those patients who are treated for early Lyme disease and have significant post-treatment illness, as they have both residual symptoms and impact on daily life functioning. With further refinement and improvement of this operationalized definition, the true incidence of PTLDS can be determined and future studies can be designed to examine its pathophysiology and treatment.
AB - Objectives: The study objective is to demonstrate the clinical and research utility of an operationalized definition of post-treatment Lyme disease syndrome (PTLDS), as proposed by the Infectious Diseases Society of America. Methods: Seventy-four patients with confirmed erythema migrans and 14 controls were enrolled. Patient-reported symptoms and health function (SF-36) were collected pre-treatment and at follow-up visits over 6 months post-treatment. Results: Eight (11%) patients met our operationalized definition of PTLDS, which included self-reported symptoms of fatigue, widespread musculoskeletal pain or cognitive complaints, and functional impact as measured by a T score of <45 on the composite SF-36. No controls met the functional impact criteria. Forty-three (60% patients returned to their previous health status when measured at 6 months post-treatment. Twenty (28%) patients had either residual symptoms or functional impact, but not both, and did not meet criteria for PTLDS. Conclusions: This operationalized definition of PTLDS allows for identification of those patients who are treated for early Lyme disease and have significant post-treatment illness, as they have both residual symptoms and impact on daily life functioning. With further refinement and improvement of this operationalized definition, the true incidence of PTLDS can be determined and future studies can be designed to examine its pathophysiology and treatment.
KW - Function
KW - Lyme disease
KW - Measurement
KW - Post-treatment Lyme disease syndrome
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U2 - 10.1016/j.ijid.2013.01.008
DO - 10.1016/j.ijid.2013.01.008
M3 - Article
C2 - 23462300
AN - SCOPUS:84877119363
SN - 1201-9712
VL - 17
SP - e443-e449
JO - International Journal of Infectious Diseases
JF - International Journal of Infectious Diseases
IS - 6
ER -