No correlation between symptom duration and intrathecal production of IgM and/or IgG antibodies in Lyme neuroborreliosis – a retrospective cohort study in Denmark - 13/10/22
, Sigurdur Skarphédinsson a, b, c, Thøger Gorm Jensen a, b, d, Fredrikke Christie Knudtzen a, b, cHighlights |
• | No association between symptom delay and presence of CSF B.burgdorferi IgM and/or IgG. |
• | Most of LNB patients do not convert from B.burgdorferi IgM to IgG antibodies in CSF. |
• | Type of CSF antibodies associated with different LNB symptom presentations. |
• | B.burgdorferi CSF antibody type cannot be used to interpret stage of disease in LNB. |
Abstract |
Objectives |
In Europe, a definite diagnosis of Lyme neuroborreliosis (LNB) requires intrathecally produced Borrelia-specific antibodies. We aimed to examine if the time from symptom debut to lumbar puncture (LP) correlated with findings of intrathecal production of Borrelia-specific IgM and/or IgG antibodies in LNB
Methods |
A retrospective study of 544 patients with a positive Borrelia burgdorferi antibody index (Bb-AI) analysed at the Department of Clinical Microbiology, Odense University Hospital, Denmark, between 01.01.1995 and 31.12.2020
Results |
The delay from symptom onset to LP for patients with positive Bb-AI IgM was 30 days (IQR 14–95 days), IgG 24 days (IQR 11–62), IgM+IgG 24 days (IQR 14–48), P = 0.098. Ninety-three patients had a second LP after median 125 days (IQR 28–432) and 25 had a third LP after median 282 days (IQR 64–539). Most patients (66.7%) did not convert from their initial intrathecal antibody finding. The prevalence of different clinical manifestations differed significantly between the three Bb-AI groups.
Conclusions |
Intrathecal Borrelia-specific antibody production did not follow the typical immune response of initial IgM production followed by IgG production. Diagnosis of LNB stage should not be based on the type of antibodies found in the cerebrospinal fluid.
Le texte complet de cet article est disponible en PDF.Keywords : Lyme neuroborreliosis, Borrelia burgdorferi sensu lato, Cerebrospinal fluid, Intrathecal borrelia burgdorferi antibody index
Plan
Vol 85 - N° 5
P. 507-512 - novembre 2022 Retour au numéro
Article précédent
- Drug resistance characteristics and molecular typing of Escherichia coli isolates from neonates in class A tertiary hospitals: A multicentre study across China
- Song Gu, Jidong Lai, Wenqing Kang, Yangfang Li, Xueping Zhu, Tongzhen Ji, Jinxing Feng, Liping Zhao, Zhankui Li, Lijie Dong, Guoqiang Hou, Yao Zhu, Zhaohui Li, Canlin He, Haifeng Geng, Dan Pang, Yajuan Wang
- Impact of urinary tract infection-causative microorganisms on the progression to bloodstream infection: A propensity score-matched analysis
- Min Hyuk Choi, Dokyun Kim, Yongjung Park, Seok Hoon Jeong
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?