Laboratory diagnosis of Lyme neuroborreliosis is influenced by the test used: Comparison of two ELISAs, immunoblot and CXCL13 testing
| Autor: | Nora Wutte, Elisabeth Aberer, Elisabeth Daghofer, Brian A. Crowe, Werner Zenz, Franz Fazekas, Juan J. Archelos |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Enzyme-Linked Immunosorbent Assay Intrathecal Sensitivity and Specificity Gastroenterology Diagnosis Differential Young Adult Predictive Value of Tests Borrelia Internal medicine Humans Lyme Neuroborreliosis Medicine CXCL13 Child Aged biology business.industry Middle Aged biology.organism_classification medicine.disease Chemokine CXCL13 Neurology Borrelia burgdorferi biology.protein Female Neurology (clinical) Antibody business Neuroborreliosis |
| Zdroj: | Journal of the Neurological Sciences. 347:96-103 |
| ISSN: | 0022-510X |
| Popis: | Purpose To compare Borrelia -specific intrathecal antibodies by two different ELISAs, an immunoblot (IB) and CXCL13. Methods Twenty-seven adults and 23 children with clinical symptoms compatible with NB were tested for Borrelia -specific intrathecal antibodies by flagellum ELISA-AI (flELISA), a recombinant ELISA-AI (rELISA) and by IB. Patients were classified according to the European Federation of Neurological Societies (EFNS) criteria as definite NB, possible NB, or non-NB. CSF CXCL13 levels were measured by ELISA. Results Among 50 patients, definite NB was diagnosed with the rELISA-AI in 29 (58%) patients, confirmed by IB in 19/29 patients, with flELISA-AI in 17 (34%) patients, confirmed by IB in 15/17 patients, and with IB in 20 (40%) patients. CXCL13 was positive in 22 (44%) patients. In 4 of 8 patients with negative AI, IB showed many detectable bands both in the CSF and serum. Conclusions The diagnosis of NB strongly relies on the used test method. The rELISA-AI test appears to be the most sensitive while the flELISA-AI is the least sensitive. However when the ELISA-AIs were confirmed by IB, different patients were identified as NB, while only 26% were identified by all performed test methods. There is a demand for standardized test methods with well-defined sensitivity and specificity to establish validated diagnostic criteria for NB including the use of the IB assay and CXCL13 as an additional non- Borrelia specific determinant in early NB. |
| Databáze: | OpenAIRE |
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