Literature DB >> 20977545

The diagnostic spectrum in patients with suspected chronic Lyme neuroborreliosis--the experience from one year of a university hospital's Lyme neuroborreliosis outpatients clinic.

M Djukic1, C Schmidt-Samoa, R Nau, N von Steinbüchel, H Eiffert, H Schmidt.   

Abstract

BACKGROUND AND
PURPOSE: Studies addressing the diagnostic relevance of anti-Borrelia burgdorferi (BB) serum antibodies in patients with non-specific symptoms and suspected chronic Lyme neuroborreliosis (LNB) are scarce.
METHODS: In this study, we enrolled within 1 year 122 patients with suspected chronic LNB. One hundred and fourteen patients had previously tested positive for BB. All patients had previously received antibiotic treatment. Each patient received a clinical examination and measurement of BB-specific antibodies. The diagnosis of neuroborreliosis was made according to the national guidelines of the German Society of Neurology. Nine patients had acute borreliosis. One of the nine met the criteria of acute LNB. Of the remaining 113 patients, 85 patients underwent a lumbar puncture. Ten seronegative subjects without lumbar puncture were also considered. In 61.8% of these 95 patients the quality of life, of sleep, mood, and anxiety were assessed.
RESULTS: Of 95 patients, 25.3% had symptoms without a somatic cause or evidence of borreliosis, 38.9% had a well-defined illness unrelated to BB infection, and 29.5% suffered from symptoms without a detectable somatic cause, displaying antibodies against BB. Six patients were grouped as post-LNB syndrome. Most common symptoms in all categories were arthralgia, myalgia, dysaesthesia, depressive mood and chronic fatigue.
CONCLUSION: Patients with persistent symptoms with elevated serum antibodies against BB but without signs of cerebrospinal fluid inflammation require further diagnostic examinations to exclude ongoing infection and to avoid co-infections and other treatable conditions (e.g. autoimmune diseases). One patient with acute LNB, who was treated with ceftriaxone for 3 weeks suffered from LNB with new headaches and persistent symptoms 6 months later. These data should encourage further studies with new experimental parameters.
© 2010 The Author(s). European Journal of Neurology © 2010 EFNS.

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Year:  2010        PMID: 20977545     DOI: 10.1111/j.1468-1331.2010.03229.x

Source DB:  PubMed          Journal:  Eur J Neurol        ISSN: 1351-5101            Impact factor:   6.089


  10 in total

Review 1.  Chronic Lyme disease.

Authors:  Paul M Lantos
Journal:  Infect Dis Clin North Am       Date:  2015-06       Impact factor: 5.982

Review 2.  A systematic review of Borrelia burgdorferi morphologic variants does not support a role in chronic Lyme disease.

Authors:  Paul M Lantos; Paul G Auwaerter; Gary P Wormser
Journal:  Clin Infect Dis       Date:  2013-12-12       Impact factor: 9.079

Review 3.  Lyme neuroborreliosis-epidemiology, diagnosis and management.

Authors:  Uwe Koedel; Volker Fingerle; Hans-Walter Pfister
Journal:  Nat Rev Neurol       Date:  2015-07-28       Impact factor: 42.937

4.  Guidelines for diagnosis and treatment in neurology - Lyme neuroborreliosis.

Authors:  Sebastian Rauer; Stephan Kastenbauer; Heidelore Hofmann; Volker Fingerle; Hans-Iko Huppertz; Klaus-Peter Hunfeld; Andreas Krause; Bernhard Ruf; Rick Dersch
Journal:  Ger Med Sci       Date:  2020-02-27

5.  Acute Lyme neuroborreliosis with transient aphasia - Case report and review of current knowledge.

Authors:  Flávia Cunha; Joana Alves Duarte; Raquel Gonçalves
Journal:  IDCases       Date:  2022-02-04

6.  The Diagnostic Challenges and Clinical and Serological Outcome in Patients Hospitalized for Suspected Lyme Neuroborreliosis.

Authors:  Violeta Briciu; Mirela Flonta; Daniel Leucuța; Mihaela Lupșe
Journal:  Microorganisms       Date:  2022-07-11

7.  Bull's-Eye and Nontarget Skin Lesions of Lyme Disease: An Internet Survey of Identification of Erythema Migrans.

Authors:  John N Aucott; Lauren A Crowder; Victoria Yedlin; Kathleen B Kortte
Journal:  Dermatol Res Pract       Date:  2012-10-24

8.  Neurocognitive functions and brain atrophy after proven neuroborreliosis: a case-control study.

Authors:  Holger Schmidt; Marija Djukic; Klaus Jung; Manfred Holzgraefe; Peter Dechent; Nicole von Steinbüchel; Joachim Blocher; Helmut Eiffert; Carsten Schmidt-Samoa
Journal:  BMC Neurol       Date:  2015-08-19       Impact factor: 2.474

9.  Application of Nanotrap technology for high sensitivity measurement of urinary outer surface protein A carboxyl-terminus domain in early stage Lyme borreliosis.

Authors:  Ruben Magni; Benjamin H Espina; Ketul Shah; Benjamin Lepene; Christine Mayuga; Temple A Douglas; Virginia Espina; Sally Rucker; Ross Dunlap; Emanuel F Iii Petricoin; Mary Frekko Kilavos; Donald M Poretz; Gilbert R Irwin; Samuel M Shor; Lance A Liotta; Alessandra Luchini
Journal:  J Transl Med       Date:  2015-11-04       Impact factor: 5.531

10.  Post-treatment Lyme disease symptoms score: Developing a new tool for research.

Authors:  Siu P Turk; Keith Lumbard; Kelly Liepshutz; Carla Williams; Linden Hu; Kenneth Dardick; Gary P Wormser; Joshua Norville; Carol Scavarda; Donna McKenna; Dean Follmann; Adriana Marques
Journal:  PLoS One       Date:  2019-11-11       Impact factor: 3.240

  10 in total

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