High frequency of false positive IgM immunoblots for Borrelia burgdorferi in Clinical Practice.

Division of Infectious Diseases, New York Medical College, Valhalla, NY, USA.
Clinical Microbiology and Infection (Impact Factor: 4.58). 12/2011; DOI: 10.1111/j.1469-0691.2011.03749.x
Source: PubMed

ABSTRACT Clin Microbiol Infect ABSTRACT: Although it is known that two-tier serologic testing for Lyme disease may be associated with false positive results on the IgM immunoblot, this problem has never been systematically studied in the clinical practice setting. In a retrospective investigation of patients referred to the private adult practice of an Infectious Diseases physician for possible for Lyme disease, 50 of 182 patients (27.5%, 95% CI: 21.1-34.6) were found to have a false positive IgM immunoblot. 78.0% of these patients had received unnecessary antibiotic therapy. False positive results were not restricted to any single commercial laboratory. Research on alternative testing strategies that eliminate the IgM immunoblot entirely is warranted.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Обзор литературы посвящен тактике ведения пациентов с длительно сохраняющимися субъективными жалобами после адекватной этиотропной терапии клещевого боррелиоза. На основе анализа современных доказательных дан-ных показано различие между терминами «хронический боррелиоз» и «постлаймский синдром», приведены факты, указывающие на отсутствие длительной персистенции возбудителя заболевания в организме хозяина. Сформулированы критерии постановки диагноза «постлаймский синдром», описаны возможные предикторы его возникновения, а также спектр возможных заболеваний и нарушений, с которыми необходимо проводить дифференциальную диагностику. Особое внимание уделено тактике ведения пациентов с постлаймским синдромом в клинической практике. Ключевые слова: Borrelia burgdorferi, постлаймский синдром, фибромиалгия, хронический клещевой боррелиоз
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Lyme Borreliosis is an infectious disease caused by the spirochete Borrelia burgdorferi that is transmitted through the bite of infected ticks. Both B cell-mediated humoral immunity and T cell immunity develop during natural Borrelia infection. However, compared with humoral immunity, the T cell response to Borrelia infection has not been well elucidated. In this study, a novel T cell-based assay was developed and validated for the sensitive detection of antigen-specific T cell response to B. burgdorferi. Using interferon-g as a biomarker, we developed a new enzyme-linked immunospot method (iSpot Lyme™) to detect Borrelia antigen-specific effector/memory T cells that were activated in vivo by exposing them to recombinant Borrelia antigens ex vivo. To test this new method as a potential laboratory diagnostic tool, we performed a clinical study with a cohort of Borrelia positive patients and healthy controls. We demonstrated that the iSpot Lyme assay has a significantly higher specificity and sensitivity compared with the Western Blot assay that is currently used as a diagnostic measure. A comprehensive evaluation of the T cell response to Borrelia infection should, therefore, provide new insights into the pathogenesis, diagnosis, treatment and monitoring of Lyme disease.
    09/2013; 2(3):607-20. DOI:10.3390/cells2030607
  • JAMA Neurology 08/2014; 71(10). DOI:10.1001/jamaneurol.2014.1193 · 7.01 Impact Factor


1 Download