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Lyme Disease

PANDAS and Persistent Lyme Disease With Neuropsychiatric Symptoms: Treatment, Resolution, and Recovery

Cross Amy, Bouboulis Denis, Shimasaki Craig, Jones Charles Ray. Case Report: PANDAS and Persistent Lyme Disease With Neuropsychiatric Symptoms: Treatment, Resolution, and Recovery. Frontiers in Psychiatry. Vol 12, 2021. DOI:10.3389/fpsyt.2021.505941  

The subject of this case report had a concomitant diagnosis of Lyme borreliosis and PANDAS, both of which are consistent with the neuropsychiatric symptoms she experienced. As evidenced by her recovery and resolution of symptoms, treating both the Lyme infection and streptococcal infection, as well as treating the underlying autoimmune etiology of her neuropsychiatric symptoms resulted in a successful outcome. This case report and treatment history reiterates the complex and challenging nature of infection-triggered autoimmune neuropsychiatric disorders such as PANDAS and PANS and that multiple concomitant infectious agents can frequently be identified in patients suffering from these complex neuropsychiatric disorders. The presence of elevated antineuronal antibodies identified by the Cunningham Panel™ provided an aid in the diagnosis and in directing immunomodulatory treatment. The post-treatment resolution of these autoantibodies provided pathophysiological support for addressing both the infection(s) and the underlying immune system dysfunction which resulted in a positive medical outcome for this patient.

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Depressive Symptoms and Suicidal Ideation Among Symptomatic Patients With a History of Lyme Disease vs Two Comparison Groups
Doshi S, Keilp JG, Strobino B, McElhiney M, Rabkin J, Fallon BA. Depressive Symptoms and Suicidal Ideation Among Symptomatic Patients With a History of Lyme Disease vs Two Comparison Groups. Psychosomatics. 2018 Sep-Oct;59(5):481-489. doi: 10.1016/j.psym.2018.02.004. Epub 2018 Mar 1. PMID: 29606281; PMCID: PMC6119532.

The study reveals that depression is reported in 8-45% of post-treatment Lyme disease syndrome (PTLDS) patients, with limited knowledge of suicidal tendencies. A comparison of depression and suicidality between PTLDS, HIV/AIDS patients, and a non-patient group shows a significant increase in suicidal tendencies among depressed individuals. Depression levels in PTLDS and HIV/AIDS patients are statistically similar. The study emphasizes that one in five PTLDS patients reported suicidal thoughts, underscoring the need for screening depression and suicidality to enhance patient care.

Two-Tier Lyme Disease Serology Test Results Can Vary According to the Specific First-Tier Test Used

Alexandra B Maulden, Aris C Garro, Fran Balamuth, Michael N Levas, Jonathan E Bennett, Desiree N Neville, John A Branda, Lise E Nigrovic, for Pedi Lyme Net, Two-Tier Lyme Disease Serology Test Results Can Vary According to the Specific First-Tier Test Used, Journal of the Pediatric Infectious Diseases Society, Volume 9, Issue 2, June 2020, Pages 128–133, https://doi.org/10.1093/jpids/piy133

Significant variations in two-tier Lyme disease test results were observed in many children, depending on the specific first-tier test utilized. When dealing with children with a strong clinical suspicion of Lyme disease and an initially negative test result, clinicians should contemplate retesting for Lyme disease.