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Implications of gender in chronic Lyme disease.

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Abstract

BACKGROUND:

"Post-
Lyme disease syndrome" refers to prolonged subjective symptoms after antibiotic treatment and resolution of an objective manifestation of Borrelia burgdorferi infection (
Lyme disease). "Chronic
Lyme disease" is a vaguely defined term that has been applied to patients with unexplained prolonged subjective symptoms, whether or not there was or is evidence of B. burgdorferi infection.

OBJECTIVE:

To determine if the population of patients with chronic
Lyme disease differs from the populations of patients with either
Lyme disease or post-
Lyme disease syndrome by examining the gender of patients with these diagnoses.

METHODS:

Data on gender were compiled in this cross-sectional study based on a systematic review of published studies of antibiotic treatment in United States patients with post-
Lyme disease syndrome (n = 184) or chronic
Lyme disease (n = 490), and on cases of adults with
Lyme disease reported to the Centers for
Disease Control and Prevention from 2003 to 2005 (n = 43,282).

RESULTS:

Patients with chronic
Lyme disease were significantly more likely to be female than were patients diagnosed with either
Lyme disease (odds ratio [OR] 2.42, 95% confidence interval [CI] 1.98-2.94, p < 0.0001) or with post-
Lyme disease syndrome (OR 2.32, 95% CI 1.62-3.34, p < 0.0001).

CONCLUSIONS:

Patients with chronic
Lyme disease differ with regard to gender from those with either B. burgdorferi infection or post-
Lyme disease syndrome. This finding suggests that illnesses with a female preponderance, such as fibromyalgia, chronic fatigue syndrome, or depression, may be misdiagnosed as chronic
Lyme disease.

J Womens Health (Larchmt). 2009 Jun;18(6):831-4. doi: 10.1089/jwh.2008.1193. Research Support, N.I.H., Extramural

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