Abstract | BACKGROUND: MATERIAL AND METHODS: We analyzed the serological findings, by anti- flagellin assay, in 267 patients with neurological symptoms from the Stockholm area, where Lyme borreliosis is endemic. RESULTS: In the 70 children with LNB, intrathecal Borrelia antibody production was diagnostic and found in 50 (71%). Sixteen (23%) showed an elevated antibody titer in serum only, and 4 (7%) had no serologic findings. Borrelia IgG in serum, with or without concomitant IgM, was a specific (98%), but insensitive (43%) marker of infection. Isolated, false-positive serum IgM titers were common and found in 10 of 67 children (15%) with viral meningitis, as well as in 28 of 111 (25%) with various neurological symptoms and normal CSF. The specificity of an isolated Borrelia IgM titer in serum was 81%, and the positive predictive value for Borrelia infection only 50% in our material. On the other hand, absence of antibodies in blood had a negative predictive value of 94%, which increased to 97% if also CSF findings were included. CONCLUSIONS: Intrathecal antibody production is strongly supportive of an LNB diagnosis. Conversely, isolated, elevated levels of Borrelia IgM in serum occur in up to one-fourth of children with various neurological complaints, and should be interpreted with caution, especially in nonendemic areas.
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Authors | R Bennet, V Lindgren, B Zweygberg Wirgart |
Journal | Infection
(Infection)
Vol. 36
Issue 5
Pg. 463-6
(Oct 2008)
ISSN: 0300-8126 [Print] Germany |
PMID | 18791841
(Publication Type: Journal Article)
|
Chemical References |
- Antibodies, Bacterial
- Immunoglobulin G
- Immunoglobulin M
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Topics |
- Antibodies, Bacterial
(blood, cerebrospinal fluid)
- Borrelia
(immunology)
- Child
- Child, Preschool
- Female
- Humans
- Immunoglobulin G
(blood, cerebrospinal fluid)
- Immunoglobulin M
(blood, cerebrospinal fluid)
- Lyme Neuroborreliosis
(blood, cerebrospinal fluid, diagnosis, immunology)
- Male
- Retrospective Studies
- Sweden
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