Bai, Natalie A, Richardson, Christie S · Chronic diseases and translational medicine · 2023 · DOI
This review examined 18 studies comparing two similar chronic illnesses: posttreatment Lyme disease syndrome (PTLDS), which affects about 10% of Lyme disease patients even after antibiotic treatment, and ME/CFS. Both conditions cause severe fatigue, cognitive problems, pain, and sleep issues that last for months or years. The researchers found that patients with PTLDS experience many of the same symptoms as ME/CFS patients, suggesting these different illnesses may develop through similar biological pathways in the body.
This research suggests that understanding what causes PTLDS after Lyme disease could provide insights into ME/CFS pathogenesis, potentially leading to better diagnostic tools and treatments. By identifying commonalities between post-infectious illnesses with different triggers, researchers may uncover shared biological mechanisms that apply broadly to chronic fatigue syndromes.
This review does not prove that PTLDS and ME/CFS are the same disease or have identical causes—only that they share overlapping symptoms. It does not establish that the symptom overlap results from identical biological mechanisms; correlation in symptom presentation does not confirm identical pathogenesis. The qualitative nature of the analysis means findings represent patterns across studies rather than quantified statistical evidence.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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Primary citation
Bai, Natalie A & Richardson, Christie S (2023). Posttreatment Lyme disease syndrome and myalgic encephalomyelitis/chronic fatigue syndrome: A systematic review and comparison of pathogenesis.. Chronic diseases and translational medicine. https://doi.org/10.1002/cdt3.74
BibTeX
@article{mecfsatlas-bai-2023-posttreatment-lyme,
author = {Bai, Natalie A and Richardson, Christie S},
title = {Posttreatment Lyme disease syndrome and myalgic encephalomyelitis/chronic fatigue syndrome: A systematic review and comparison of pathogenesis.},
journal = {Chronic diseases and translational medicine},
year = {2023},
doi = {10.1002/cdt3.74},
note = {PubMed: 37711861},
url = {https://www.mecfsatlas.com/evidence/bai-2023-posttreatment-lyme},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/bai-2023-posttreatment-lyme
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