Borrelia antibodies in children evaluated for Lyme neuroborreliosis.
In: Infection, Jg. 36 (2008-10-01), Heft 5, S. 463-6
Online
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Zugriff:
Background: We wanted to elucidate the value of Borrelia antibodies in serum and cerebrospinal fluid (CSF) for the diagnosis of Lyme neuroborreliosis (LNB).
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.
Titel: |
Borrelia antibodies in children evaluated for Lyme neuroborreliosis.
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Autor/in / Beteiligte Person: | Bennet, R ; Lindgren, V ; Zweygberg Wirgart, B |
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Zeitschrift: | Infection, Jg. 36 (2008-10-01), Heft 5, S. 463-6 |
Veröffentlichung: | 2011- : Heidelberg : Springer Heidelberg ; <i>Original Publication</i>: München, Verlagsgesellschaft Otto Spatz., 2008 |
Medientyp: | academicJournal |
ISSN: | 0300-8126 (print) |
DOI: | 10.1007/s15010-008-6259-4 |
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