Universität zu Köln

Schneider, Christian, Gielen, Joerg, Roeth, Philip, Albrecht, Philipp, Schroeter, Michael, Fink, Gereon R. ORCID: 0000-0002-8230-1856, Wunderlich, Gilbert and Lehmann, Helmar C. (2020). Quantitative serological antibody testing for suspected neuroborreliosis. J. Neurol., 267 (5). S. 1476 - 1482. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1432-1459

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Abstract

Objective To assess the importance of serum IgG/IgM antibody titers for the differentiation of Lyme neuroborreliosis (LNB) from its mimics. Method This was a retrospective, cross-sectional study conducted at two German neurological centers. Serological parameters (ELISA or CLIA analysis) and clinical presentation of 28 patients with definite LNB were compared to those of 36 patients with neurological symptoms mimicking LNB (mimics). Analysis was performed using receiver operating characteristic (ROC) and binary logistic regression. Results Elevated IgG-titers had a high sensitivity for neuroborreliosis in both centers (0.95 and 1.0). The optimal cutoff-values were set to 26.35 in center A (ELISA), and 64.0 in center B (CLIA). Diagnostic specificity was 0.41 and 0.89 in this constellation. Elevated IgM-titers showed a high diagnostic specificity for a cutoff at 68.10 (A) and 47.95 (B) (0.93 and 0.89). Sensitivity was 0.45 and 0.5. Overall diagnostic accuracy was low in both centers (A: IgG AUC = 0.665, IgM AUC = 0.629; B: IgG AUC = 0.917, IgM AUC = 0.556). In logistic regression of antibody titers and clinical measures, prediction of LNB was significantly better than the null hypothesis. Clinical measures showed the highest odds ratio. Conclusion Data show that in addition to the clinical presentation of patients with symptoms suggesting central or peripheral nervous system manifestation, serum IgG- and IgM-titers help to identify LNB-patients. The results should guide physicians counseling patients with suspected LNB about further diagnostic steps and treatment.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Schneider, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Gielen, Joerg UNSPECIFIED UNSPECIFIED UNSPECIFIED Roeth, Philip UNSPECIFIED UNSPECIFIED UNSPECIFIED Albrecht, Philipp UNSPECIFIED UNSPECIFIED UNSPECIFIED Schroeter, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Fink, Gereon R. UNSPECIFIED orcid.org/0000-0002-8230-1856 UNSPECIFIED Wunderlich, Gilbert UNSPECIFIED UNSPECIFIED UNSPECIFIED Lehmann, Helmar C. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-347670
DOI:	10.1007/s00415-020-09721-7
Journal or Publication Title:	J. Neurol.
Volume:	267
Number:	5
Page Range:	S. 1476 - 1482
Date:	2020
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1432-1459
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language BORRELIA-BURGDORFERI; CHEMILUMINESCENCE IMMUNOASSAY; FOLLOW-UP; D-DIMER; DIAGNOSIS; ELISA Multiple languages Clinical Neurology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/34767