Exhaustion – Is it Lyme Disease or Chronic Fatigue Syndrome?

One of the late effects of Lyme Disease, seen in only some patients, is a syndrome of chronic fatigue and cognitive dysfunction (e.g. difficulty in reasoning and making decisions); it’s called Neurologic Post Treatment Lyme disease syndrome.  Debilitating fatigue and cognitive dysfunction are also commonly seen in patients who’ve been diagnosed with the Chronic Fatigue Syndrome.  Indeed, at times it’s almost impossible to distinguish between the two conditions. Now a study described in the Journal PLoS ONE provides a method of distinguishing between the two conditions.

 Scientists from New Jersey, New York and Washington analyzed spinal fluid from three groups of individuals. The first group consisted of 43 patients with Chronic Fatigue Syndrome, the second group were 25 patients who had been diagnosed and treated for Lyme disease but who had not completely recovered, and the third group was 11 healthy controls. The proteome – the collection of proteins found in individual spinal fluid – was used to obtain a fingerprint that was unique to a group, and also unique to each person. There were 2,500 proteins in the fingerprint of each group; these included 738 proteins unique to the Chronic Fatigue Syndrome group and 692 unique to the Lyme disease group.

This means that spinal fluid proteins can probably be used as a marker of disease, perhaps for other diseases that present diagnostic difficulties. In the case of these two conditions, there were a number of proteins that were common to both groups, but in different amounts; the researchers felt this could be a sign of both conditions being triggered by infection, but from different causes. Thus all cases of Lyme disease are triggered by the bacteria B burgdorferi, whereas the agent triggering Chronic Fatigue Syndrome is, as yet, unknown.

This is an exciting study, as it paves the way for improved diagnostics and further understanding of causation of problem diseases. It's unfortunate that it involves a spinal tap, something that is often considered unpleasant by most patients.