ABSTRACT
A total of 176 sera from 73 patients with verified Lyme borreliosis at different stages of the disease are examined. Serological diagnosis was carried out by 2 methods: indirect immunofluorescence (IIF) with corpuscular B. burgdorferi antigen and enzyme immunoassay (EIA) with purified flagellar B. burgdorferi antigen (Dako). EIA with Dako antigen is more sensitive for the diagnosis of Lyme borreliosis at any period of the disease than IIF. Analysis of correlations between the results of IIF and EIA showed correlation in the levels of IgG but not IgM antibodies. The findings confirmed a previous hypothesis that inadequate antibacterial therapy before investigation decreases the level of antibodies to Borrelia. In patients with a history of Lyme borreliosis, antibodies to B. burgdorferi are detected less frequently by both IIF and EIA. Patients with persistent levels of antibodies to B. burgdorferi, even without clinical signs of infection, are in need of regular check-ups, because the prognostic significance of antibodies to B. burgdorferi is unknown and relapses may occur after months and years.
Subject(s)
Fluorescent Antibody Technique, Indirect , Immunoenzyme Techniques , Lyme Disease/diagnosis , Adolescent , Adult , Aged , Antibodies, Bacterial/analysis , Borrelia burgdorferi Group/immunology , Female , Humans , Immunoglobulin G/analysis , Immunoglobulin M/analysis , Male , Middle Aged , Prognosis , RecurrenceABSTRACT
The paper presents comparative clinical and laboratory characteristics of 17 cases of Lyme-arthritis (LA) and 28 cases of reactive arthritis (RA). LA and RA patients differed by age and sex. LA arose after the tick bite followed by erythema migrans or infection symptoms. In RA patients the above symptoms were absent. In LA patients arthritis was associated with typical symptoms of neuroborreliosis. The articular syndrome manifested similarly in LA and RA: arthritis was preceded by arthralgias, low limb joints and periarticular tissues were involved most frequently. The differences were: monoarthritis, elbow and shoulder joints, muscles lesions occurred more frequently in LA; polyarthritis, arthritis of hand and foot joints, talalgia were more common in RA. RA ran more actively, joint syndrome more frequently gave rise to fever. Prevalence of chlamydial infection in LA was close to that in RA. LA may run as RA, is frequently combined with Chlamydia trachomatis infection.
Subject(s)
Arthritis, Reactive/diagnosis , Chlamydia Infections/diagnosis , Chlamydia trachomatis , Lyme Disease/diagnosis , Aged , Antibodies, Bacterial/blood , Borrelia burgdorferi Group/immunology , Chlamydia trachomatis/isolation & purification , Diagnosis, Differential , Erythema Chronicum Migrans/diagnosis , Female , Humans , Male , Middle AgedABSTRACT
Clinical and laboratory data are available on affection of the peripheral nervous system (PNS) in 27 patients with Lyme-borreliosis (LB) in the endemic region of Russia. PNS disorders arose early, 88.9% of the patients had them within one month of the disease. 9 (37.5%) patients had meningoradiculoneuropathy (MRN) which emerged in the acute period in 77.8% of the patients. Inflammation in the cerebrospinal fluid was registered only in patients with clinical signs of meningitis. MRN developed more frequently in facial nerve neuritis (FNN) than in radiculopathy (RP)-80.0% and 14.3%, respectively, p = 0.01. Intrathecal synthesis of antibodies to B. burgdorferi in combination with pleocytosis was found only in FNN patients (16.7%). In 6 (37.5%) of 16 patients with neuroborreliosis concentrations of C-reactive protein were elevated. Its high level occurred significantly more frequently in RP (83%) than in FNN (17%) (p = 0.05). 5 out of 14 LB patients exhibited high level of Willebrand factor antigen. No clear clinical relations between this value and PNS lesions in LB were found.
