Coyle P K, Krupp L B, Doscher C, Amin K
Department of Neurology, Health Sciences Center, SUNY, Stony Brook 11794.
Clin Infect Dis. 1994 Jan;18 Suppl 1:S24-7. doi: 10.1093/clinids/18.supplement_1.s24.
Borrelia burgdorferi is the pathogen that causes Lyme disease. Patients frequently experience fatigue and malaise that can persist after antibiotic treatment. This study examined serological reactivity to B. burgdorferi in patients with chronic fatigue who were from a region in which Lyme disease is endemic. Blood and CSF were collected from patients without a history of infection due to B. burgdorferi (n = 12) and patients with persistent fatigue after antibiotic treatment of Lyme disease (n = 13). Serum and CSF were examined by ELISA for antibodies to B. burgdorferi, and routine studies of CSF were done. In the first group, one patient (8%) was seropositive; no patients had detectable antibodies in CSF. In the second group, nine patients (69%) were seropositive or borderline seropositive; seven (54%) had detectable antibodies in CSF. Unexplained abnormalities in CSF were noted in 42% and 31% of patients in each group, respectively. In this study positive serologies for Lyme disease were not found at a higher than expected rate for patients from a region of Lyme disease endemicity who had idiopathic chronic fatigue. Fatigued patients did show a surprisingly high rate of unexplained minor CSF abnormalities suggestive of CNS or meningeal dysfunction.
伯氏疏螺旋体是引发莱姆病的病原体。患者经常会出现疲劳和不适症状，且在抗生素治疗后仍可能持续。本研究检测了来自莱姆病流行地区的慢性疲劳患者对伯氏疏螺旋体的血清学反应。从无伯氏疏螺旋体感染史的患者（n = 12）和莱姆病抗生素治疗后仍持续疲劳的患者（n = 13）中采集血液和脑脊液。通过酶联免疫吸附测定（ELISA）检测血清和脑脊液中针对伯氏疏螺旋体的抗体，并对脑脊液进行常规检查。在第一组中，有1名患者（8%）血清学呈阳性；脑脊液中未检测到抗体。在第二组中，9名患者（69%）血清学呈阳性或临界阳性；7名患者（54%）脑脊液中检测到抗体。每组分别有42%和31%的患者脑脊液中存在无法解释的异常。在本研究中，对于来自莱姆病流行地区且患有特发性慢性疲劳的患者，莱姆病血清学阳性率并未高于预期。疲劳患者确实表现出异常高比例的无法解释的轻微脑脊液异常，提示存在中枢神经系统或脑膜功能障碍。
