Testing for Lyme borreliosis: could serology tell more?

Authors : András ZÓKA, Márton GÖNCZY, Veronika BARBAİ, Radka NİKOLOVA, Eszter UJHELYİ, Zsuzsa KİENLE, Gabriella BEKŐ

Pages : 85-93

View : 15 | Download : 7

Publication Date : 2020-09-30

Article Type : Research Paper

Abstract :Purpose: Remnant antibodies might be prevalent in the general population, thus recognizing relevant seropositivity might be challenging. The sequential nature of the anti-Borrelia antibody response might be diagnostically utilized. We aimed to specify details which might potentially be useful in orientating the diagnostic schedule. Methods: We processed the sera of 1304 patients using a recombinant antigen-based ELISA between Aprils of 2017 and 2019. Seroreactivity insert ignore into journalissuearticles values(when coherent with the anamnestic data); was confirmed with a line immunoassay insert ignore into journalissuearticles values(LIA);. ELISA testing insert ignore into journalissuearticles values(IgG and/or IgM); was reactive in 539 cases. 107 patients with persistent symptoms tested positive or borderline with IgG ELISA. Results: A significant difference was observed insert ignore into journalissuearticles values(Mann-Whitney U-test p=0.003); between the LIA scores of patients with characteristic insert ignore into journalissuearticles values(arthritis, acrodermatitis, neuropathy, other objective neurologic disorder; n=83; median LIA score: 16); and non-specific symptoms insert ignore into journalissuearticles values(entirely subjective complaints, other known disease, lone subfebrility, uveitis; n=24; median LIA score: 6);. 101 of the 107 patients tested positive for IgG against any specific protein by LIA. Those with a LIA score reaching the group median of 15 insert ignore into journalissuearticles values(n=51); displayed strong anti-VlsE IgG positivity or a typical late IgG antibody insert ignore into journalissuearticles values(against p100, p18 or p39); more often than those below insert ignore into journalissuearticles values(88,2% vs. 30% and 100% vs. 38% respectively, Χ2 p<0.0001);. Conclusions: Weak LIA positivity insert ignore into journalissuearticles values(especially anti-VlsE IgG); in combination with the lack of late antibodies in patients with persistent symptoms might suggest the presence of remnant antibodies and prompt scrupulous differential diagnosis.
Keywords : serology, Lyme borreliosis, differential diagnosis