title: Divergent opinions of proper Lyme disease diagnosis and implications for children co-morbid with autism spectrum disorder.
abstract: This paper proposes that some children with an autism spectrum disorder (ASD) in the United States have undiagnosed Lyme disease and different testing criteria used by commercial laboratories may be producing false negative results. Two testing protocols will be evaluated; first, the Centers for Disease Control (CDC) and Infectious Disease Society of America (IDSA) approved two-tiered Enzyme Immunoassay (EIA) or Immunofluorescence Assay (IFA) followed by an IgM and/or IgG Western Blot test. Second, a clinical diagnosis (flu like symptoms, joint pain, fatigue, neurological symptoms, etc.) possibly followed by a Western Blot with a broader criteria for positive bands [1]. The hypothesis proposes that the former criteria may be producing false negative results for some individuals diagnosed with an ASD. Through an online survey parents of 48 children who have a diagnosis of an ASD and have been diagnosed with Lyme disease were asked to fill out the Autism Treatment Evaluation Checklist (ATEC) before they started antibiotic therapy and after treatment. Of the 48 parents surveyed 45 of them (94%) indicated their child initially tested negative using the two-tiered CDC/IDSA approved test. The parents sought a second physician who diagnosed their child with Lyme disease using the wider range of Western Blot bands. The children were treated with antibiotics and their scores on the ATEC improved. Anecdotal data indicated that some of the children achieved previously unattained developmental milestones after antibiotic therapy began. Protein bands OSP-A and/or OSP-B (Western Blot band 31) and (Western Blot band 34) were found in 44 of 48 patients. These two bands are so specific to Borrelia burgdorferi that they were targeted for use in vaccine trials, yet are not included in the IDSA interpretation of the Western Blot.
authors.affiliation: University of Northern Iowa, Department of Curriculum and Instruction, 1227 W 27th St, Cedar Falls, IA 50614, USA. Electronic address: MasonKuhn@hotmail.com.
authors.forename: Mason
authors.initials: M
authors.lastname: Kuhn
authors.affiliation: Robert Wood Johnson University of Medicine and Dentistry Medical School, Education and Research Building, 401 Haddon Avenue, Camden, NJ 08103, USA. Electronic address: bransfield@comcast.net.
authors.forename: Robert
authors.initials: R
authors.lastname: Bransfield
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D018771:Arthralgia / Q000503:physiopathology; D000067877:Autism Spectrum Disorder / Q000503:physiopathology*; D025065:Borrelia burgdorferi; D002487:Centers for Disease Control and Prevention, U.S.; D002648:Child; D015897:Comorbidity; D003937:Diagnosis, Differential; D005188:False Negative Reactions; D005221:Fatigue / Q000503:physiopathology; D006801:Humans; D007124:Immunoenzyme Techniques; D020407:Internet; D008193:Lyme Disease / Q000175:diagnosis* / Q000503:physiopathology*; D010290:Parents; D011795:Surveys and Questionnaires; D014481:United States
chemical_list: D000900:Anti-Bacterial Agents