
What Causes Tingling Sensation In Hands, Confusion, Migraine And Chest Pain?

?Lyme disease
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
You have myriad of symptoms related to cardiovscualar, musculo-skeletal, GI,Neurological system and hematological abnormality . You have undergone extensive work-up probing all involved system but nothing positive conclusion could be drawn as they are mostly normal.
Only pointer is ELISA Lyme tests which showed higher reading on successive tests..Positive ELISA Lyme tests should be followed by western blotting (IgM & IgG).
Chronic Lyme Disease may be associated with chronic fatigue syndrome or fibromyalgia.
To my mind ,you have to exclude treatable cause before labeling the symptoms functional or stress related.
Regards
Dr. T.K. Biswas M.D. XXXXXXX


Lyme disease-diagnostic work-up
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
I agree Lyme disease may cause diagnostic confusion.
Serologic testing may yield negative results during the first
several weeks of infection;however almost all patients have a positive antibody response to B. burgdorferi after that time.
You are having symptoms since May i.e more than 20 weeks or so.
ELISA can have false positives in Lyme disease.
In persons with illness of >2 months’ duration, a positive IgM
test result alone is likely to be false-positive and therefore should not
be used to support the diagnosis.
Western blot:
According to current criteria adopted by the CDC, an IgM western
blot is considered positive if two of the following three bands are present:
23, 39, and 41 kDa. However, the combination of two such bands
may still represent a false-positive result. Misuse or misinterpretation
of IgM blots has been a factor in the incorrect diagnosis of Lyme disease
in patients with other illnesses.
In your case western blot IgM had only one band of 23 kDa.
An IgG blot is considered positive if 5 of the following 10 bands are present: 18, 23, 28, 30, 39, 41, 45,58, 66, and 93 kDa.
In your case western blot IgG had only one band of 41 kDa.
Since the serological tests (standard two-test approach) so far done are equivocal ,you may go for second-generation serologic test - the VlsE C6 peptide IgG ELISA, which employs a 26-mer of the sixth invariant region of the VlsE lipoprotein of B. burgdorferi (causative organism of Lyme disease).
Enlarged spleen indicates possibility of Disseminated Infection/Early Infection: Stage 2.
Regards
Dr. T.K. Biswas M.D. XXXXXXX


Lyme disease-second-generation serologic test
Detailed Answer:
You are most welcome
regards
Dr Biswas

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