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Lyme borreliosis: significance of the serological diagnosis of an infection with Borrelia burgdorferi in neurological diseases with inflammatory cerebrospinal fluid syndrome.

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Abstract

To look for a correlation between positive antibody-response against Borrelia burgdorferi (Bb) and an inflammatory CSF-syndrome, from May 1988 to May 1989 333 patients from the Neurological Department of the University of Bern underwent lumbar puncture with cell count, quantitative and qualitative protein analysis and antibody determination against Bb in serum and CSF. 6 patients with active syphilis were excluded. The results of the 333 remaining patients were analyzed using chi 2 or Fisher’s exact test. The antibody determination was performed using an immunoperoxidase assay (IPA). Our results are calculated for three cut-off points: Bb-IgG 1:64, 1:128, 1:256 and/or Bb-IgM 1:16, 1:32, 1:64. We found 11.7% patients to be seropositive (Bb-IgG 1: greater than or equal to 256 and/or Bb-IgM 1: greater than or equal to 64). We demonstrated the following correlations: elevated cell count (greater than 10/mm3 cells CSF) versus elevated Bb-titer (1: greater than or equal to 256), elevated total protein of CSF (greater than 48 mg%) versus elevated Bb-titer, blood-brain-barrier dysfunction versus elevated Bb-titer. In diagnostic subgroups, the same correlations were only demonstrated for PNS disorders (n = 134), and especially PNS-disorders without compression. 8 cases showed the high risk constellation inflammatory CSF syndrome and highly positive titer (Bb-IgG 1: greater than or equal to 256). Only 2 had typical neuroborreliosis, while in 2 cases the possibility of neuroborreliosis was open. Patients with MS did not show a special risk for Bb-infection.(ABSTRACT TRUNCATED AT 250 WORDS)

Schweiz Med Wochenschr. 1992 Jul 7;122(27-28):1029-36. Case Reports; English Abstract; Research Support, Non-U.S. Gov’t

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