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Symptoms and laboratory tests in chronic Lyme disease and coinfections 


Lyme-Borreliosis and coinfections are the chameleon of symptoms, laboratory tests and therapies. Chronic multiple symptoms for Lyme-Borreliosis and other tick-borne diseases can be chronic fatique, joint and muscle pain, neck-pain, neurological symptoms like burning hand/feet or sensitivity problems, sleeplessness, short-term memory loss, concentration problems, psychiatric problems like aggressiveness or anxiety, autoimmune disorders and over 100 other symptoms. Therefore chronic tick-borne diseases express syndromes like Chronic Fatique Syndrome, Multiple Encephalitis, Amyotrophic Lateral Sclerosis, Multiple Sclerosis, Alzheimers, Parkinsonism, Rheumatoid Arthritis, Sjogrens Syndrome, Hashimoto thyroidits, tinnitus, depressions, schizophrenia, Carpal Tunnel Syndrome, Autism etc. 

The laboratory diagnosis of tick-borne diseases and other symptom-related chronic infections is based on indirect and direct laboratory tests for different kinds of bacteria and viruses. There is a lack of confidence in falsely established laboratory tests for antibodies like the Borrelia- ELISA for tick-borne diseases including Borrelia burgdorferi, which are not standardized and very insensitive. Therapists need the practical help by better and improved laboratory tests, such as the Borrelia immunoblot  and T-cell-tests like the CD57-count or the Elispot.

Many patients with tick-borne diseases are infected by other bacteria or viruses (“multiple infections”).  The problems are in general, that most symptoms of tick-borne diseases are not high-specific for Lyme-Borreliosis or other tick-borne diseases (“overlapping symptoms”) and many ticks are contaminated with other bacteria like Ehrlichia/Anaplasma, Rickettsia, Babesia and Bartonella. There are many evidence-based studies about  Borrelia burgdorferi and Chlamydia pneumoniae as the causing agents in patients with inflammatory arthritis, Multiple Sclerosis or Alzheimers disease. Therapists should check all symptoms by anamnesis to get an individual clinical “ranking” of possible bacterial and viral infections. The next senseful step is to do laboratory tests with the best sensitivites and specificities. This should be done before starting any therapy to do the right individual therapeutical decision for the patient. 

Thepresentation aims to show the clinical “grading” and “ranking” of symptoms regarding coinfections and the laboratory “staging” processes in diagnosing tick-borne diseases and other infections by the help of modern laboratory tests.

Biography:  Dr. Armin Schwarzbach, MD, PhD is a MD and a specialist for laboratory medicine from ArminLabs, Augsburg, Germany. He began by studying biochemistry at Hoechst AG, Frankfurt/Germany and pharmacy at the University of Mainz/Germany in 1984. After that he studied medicine for 6 years at the University of Mainz/Germany and finished his MD in 1991.

Dr. Schwarzbach developed the worldwide first Radioimmunoassay (RIA) for human Gastric Inhibitory Polypeptide (hGIP) from 1986 – 1991, reaching his PhD in 1992. He worked as a medical assistant in internal medicine, oncology, cardiology, gastroenterology and infectiology afterwards for several years. By 1993 he had started specializing in laboratory medicine for another 4 years in infectiology, microbiology, immunology, hematology, clinical chemistry, endocrinology and gynecological endocrinology.

Dr. Schwarzbach took part as a SME in the FP7 scientific research program of the European Union, together with 7 other European partners from Spain, Italy, Portugal, Finland and Belgium regarding the Hilysens I project from 2011 – 2013 ( The aim of the European Hilysens I project was to develop a prototpye in form of a highly sensitive laboratory on a chip system for Borrelia burgdorferi IgG and IgM antibodies. The Hilysens I project was so successful to be followed up by the Hilysens II project of the European Union, involving Dr. Schwarzbach and 4 other European partners since April 2014. Dr. Schwarzbach is C6 Board Member of the International Lyme and Diseases Society, ILADS, USA and the Chair of the laboratory test and the international committees of ILADS. He was appointed in March 2013 as the International expert for the Chief Medical Officer´s Clinical Advisory Committee on Lyme Disease in Australia (CACLD) of the Australian Government, Department of Health and Ageing, Canberra, Australia.

In November 2013 Dr. Schwarzbach was appointend as the European expert for Lyme disease in Ireland by the Irish Parliament, Joint Committee on Health and Children, Dublin, Ireland. He is also member of the new working group for Lyme disease of the Haut Conseil de la sante publique, Paris, France. Dr. Schwarzbach is member of the German Borreliosis Society, the Swiss Association for Tick-borne diseases, the German Association of Clinical Chemistry and Laboratory Medicine, the German Society for Medical Laboratory Specialists and the Australasian Integrative Medicine Association. Dr. Schwarzbach is the founder of ArminLabs in Augsburg/GErmany and specializes in the diagnostics and treatments for patients with tick borne diseases for over 15 years now. Company: ArminLabs, Zirbelstrasse 58, Augsburg, Germany, D-86154 Phone: 0049(0)8212182879. Website