Portal de Periódicos da CAPES

Detection of Borrelia burgdorferi DNA in Muscle of Patients with Chronic Myalgia Related to Lyme Disease

1998; Elsevier BV; Volume: 104; Issue: 6 Linguagem: Inglês

10.1016/s0002-9343(98)00112-0

1555-7162

Michel Frey, B. Jaulhac, Y. Piémont, Luc Marcellin, Pierre-Michel Boohs, P. Vautravers, M Jésel, Jean‐Louis Kuntz, H. Monteil, Jean Sibilia,

Peripheral Neuropathies and Disorders

Lyme disease is a tick-borne infection caused by Borrelia burgdorferi. Myalgia occurs frequently in the disease ( 1. Steere A.C Bartenhagen N.H Craft J.E et al. The early clinical manifestations of Lyme disease. Ann Intern Med. 1983; 99: 76-82 Crossref PubMed Scopus (510) Google Scholar ). Although in some cases myalgia results from myositis ( 2. Reimers C.D de Koning J Neubert U et al. Borrelia burgdorferi myositis report of eight patients. J Neurol. 1993; 240: 278-283 Crossref PubMed Scopus (75) Google Scholar ), patients generally suffer from widespread myalgia of unknown cause. Often associated with arthralgia and fatigue, symptoms sometimes persist after appropriate antibiotic treatment. Chronic symptoms, similar to those of fibromyalgia, are often considered as sequelae of Lyme disease ( 3. Hsu V.M Patella S.J Sigal L.H Chronic Lyme disease as the incorrect diagnosis in patients with fibromyalgia. Arthritis Rheum. 1993; 36: 1493-1500 Crossref PubMed Scopus (93) Google Scholar ). Except in myositis, the persistence of B burgdorferi in the muscle tissue of patients with chronic myalgia following Lyme disease has never been demonstrated. Detection of B burgdorferi DNA by polymerase chain reaction (PCR) amplification has been reported in cerebrospinal fluid, urine, blood, skin, and synovial fluid and tissue ( 4. Jaulhac B Chary-Valckenaere I Sibilia J et al. Detection of Borrelia burgdorferi by DNA amplification in synovial tissue samples from patients with Lyme arthritis. Arthritis Rheum. 1996; 39: 736-745 Crossref PubMed Scopus (109) Google Scholar ) and in a single case report in muscle ( 5. Frey M Jaulhac B Sibilia J et al. Detection d'ADN de Borrelia burgdorferi par amplification génique dans le muscle d'un patient atteint de fibromyalgie. Presse Medicale. 1995; 24: 1623 PubMed Google Scholar ). PCR may help to distinguish active Lyme disease with persistent spirochetes from borreliosis sequelae ( 6. Steere A.C Taylor E Mc Hugh G.L Logigian E.L Overdiagnosis of Lyme disease. JAMA. 1993; 269: 1812-1816 Crossref PubMed Scopus (310) Google Scholar , 7. Malawista S.E Barthold S.W Persing D.H Fate of Borrelia burgdorferi DNA in tissues of infected mice after antibiotic treatment. J Infect Dis. 1994; 170: 1312-1316 Crossref PubMed Scopus (68) Google Scholar ). Therefore, to test the hypothesis that chronic myalgia associated with Lyme disease may be related to the persistence of B burgdorferi, we used PCR to screen patients with myalgia after confirmed Lyme disease for the presence of B burgdorferi DNA in muscle tissue.