Thursday, February 2, 2012

25 band Doxycycline

A patient has joint pain, unimpressive, and otherwise doesn't looke "Lymie."

Stony Brook's Lyme WB reports 41 and 25 IgM bands, interpreted as negative by CDC criteria.

IgenX reports the "23-25" band as a single entity and would have reported the result as CDC positive.(I think).

Bands 22,23,24 and 25 have been associated with highly specific Osp C.

Labcorp reports only the 23 band, not the 25.

Interpreting these results in a low index of suspicion case could be tricky.

Question: Is it reasonable to use IgenX criteria when interpreting results from a different lab?

After 3 weeks of doxycycline patient feels better.

Does the patient have Lyme? Is there any harm treating if Lyme seems unlikely?

It is nice to know that unlike other tetracycalines, doxycyline is excreted in the feces (not the kidneys as well) mostly as inactive conjugates or chelates - having minimal effect on intestinal flora. (Goodman and Gilman).

Other Lyme non-believers believe doxycyline and minocyline are effective for arthritis, even rheumatologist. Gabe Mirkin thinks these drugs work because mycoplasm,chlamydia and others are associated with "reactive arthritis."

Reactive arthritis is a "real" entity described in Harrison's textbook of medicine. Of course long term antibiotics are not recommended.

1 comment:

Jack George said...

Doxycycline used to treat a wide range of infections caused by bacteria such as respiratory tract infections, urinary tract infections, sexually transmitted diseases, skin infections such as acne etc