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Lyme Disease Message Board

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Yikes, how confusing for you. Lyme Disease has a lot of symptomatic overlap with autoimmune disease, so I can see why this is quandary for you.

High inflammation markers (CRP and sed rate) are consistent with both pathologies. However, you have a positive ANA and elevated liver enzymes, which you don't usually see in Lyme Disease. but you also have positive Lyme antibodies - these can be false positives though. Whether you were given the ELISA or the IFA test for antibodies, they are both pretty rubbish and only useful as general screens. They often come back with false negatives, and cross reactions with other pathogens can cause false positives too.

For Lyme testing, the way to go is with IgG and IgM western blot. The bands you have, 39 and 41, don't really clinch the diagnosis as they are pretty non-specific bands. It doesn't mean that you don't have Lyme, but it's a point against it.

Sometimes you just need to go on your response to medication. You mention that you felt better on both doxycycline and prednisone (briefly), so you can't draw many conclusions from that either. In my opinion, you should try out prednisone for a more extended period to see if it brings you relief. In the meantime, more specific tests for AA diseases might be in order (Schrimer's test/salivary gland biopsy to test for Sjogren's, for example. They can be tricky to catch too). If nothing pans out and you don't feel better after a while, it might be time to go see an LLMD.

1. Was I wrong to push for the Doxy?
-no, understandable to be confused.

2. Any opinions on if this is Lymes?
-like 50/50 at this point. the symptoms you described could be due to either Lyme or an autoimmune disease. or both!

3. Is the IgM test the same as the Western Blot test?
-there are two tests: IFA/ELISA which look for Lyme antibodies, and are notoriously unreliable. The better test is called Western Blot and looks for disease reaction on specific 'bands'...39 and 41 aren't considered specific for Lyme.

4. Should I recommend any specific new testing?
-The tests I mentioned above to definitively rule out Sjogren's may be a good idea. Also, Rheumatoid factor, and Sjogren's SS-A Ro and anti-SS-B La if you don't want to go through with a salivary gland biopsy.

Definitely get another western blot taken and sent it to Igenex Labs for a proper look.

5. It seems like, of course it's reactive arthritis, you get that with Lymes. Why is doc resistant to treating with antibiotic.
-Lyme awareness among most physicians outside of New England is pretty low. Many doctors just aren't aware of its incidence, or the litany of symptoms it can cause. Because you live in TX, an area not traditionally associated with Lyme, your doctor may be skeptical. Also, the only reactive bands you had on Western Blot were two rather insignificant ones.

6. Are there other bacteria that mimic the western blot results?
-It depends on the band - some are more specific than others. In your case, definitely other pathogens could have caused those positive reactions.

7. Should I be concerned that the Rheum may not be reading the Lymes related tests correctly since we are here in Houston and Lymes is rare here?
-I don't think he is reading them incorrectly. Reading a lab test is simple business for any doctor. The problem may be with the lab itself - labs that aren't familiar with the disease may mess up the results. It's best to go to a specialist lab, and the best one I know of is Igenex in CA.

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