ABSTRACT
Lyme disease is a multisystem disorder caused by a tick-transmitted spirochete, Borrelia burgdorferi. The diagnosis is based on clinical findings in most patients, particularly those with erythema migrans or exposure to geographic locations endemic for the disease. Detection of a specific antibody to B. burgdorferi is a useful confirmatory test in many patients. In atypical cases, however, a positive test result can be pivotal for determining the diagnosis and can lead to institution of definitive treatment. Serologic testing should not be used indiscriminately to diagnose Lyme disease or as the sole basis for administration of antibiotic therapy.
Subject(s)
Lyme Disease/immunology , Aged , Antibodies, Bacterial/analysis , Blood Sedimentation , Enzyme-Linked Immunosorbent Assay , Female , Humans , Lyme Disease/blood , Lyme Disease/drug therapy , Lyme Disease/pathology , MaleABSTRACT
Cerebrospinal fluid (CSF) samples were evaluated in an immunoglobulin M enzyme-linked immunosorbent assay (IgM ELISA) for syphilis with sonic extracts of Treponema pallidum coated on polystyrene plates. The ELISA procedure was reproducible, and T. pallidum antigens were stable., A total of 15 CSF samples from patients with neurosyphilis, 18 CSF samples from patients with syphilis, 12 CSF samples from patients treated for syphilis, and 494 CSF samples from patients with neurologic or other systemic diseases were tested. The IgM ELISA gave reactive results in all of six symptomatic and congenital neurosyphilitic patients and none of nine asymptomatic neurosyphilitic patients. Of 524 CSF samples from nonneurosyphilitic individuals, 513 were nonreactive, resulting in 98% test specificity. The IgM ELISA in CSF should prove to be useful for confirmation of symptomatic neurosyphilis.
Subject(s)
Immunoglobulin M/cerebrospinal fluid , Neurosyphilis/cerebrospinal fluid , Syphilis/cerebrospinal fluid , Treponema pallidum/immunology , Albumins/cerebrospinal fluid , Antibodies, Bacterial/cerebrospinal fluid , Blood-Brain Barrier , Enzyme-Linked Immunosorbent Assay , Humans , Neurosyphilis/diagnosis , Neurosyphilis/immunology , Syphilis/immunology , Syphilis, Congenital/cerebrospinal fluid , Syphilis, Congenital/immunologySubject(s)
Lyme Disease/diagnosis , Spirochaetales , Ticks , Animals , Disease Vectors , Humans , Lyme Disease/etiology , Lyme Disease/immunologySubject(s)
Chemistry, Clinical/instrumentation , Calibration , Evans Blue , Mathematics , SpectrophotometryABSTRACT
A simple, rapid, and quantitative immunochemical technique is described for quantitation of urinary myoglobin. The test is specific for myoglobin in the presence of hemoglobin or tissue constituents, can be completed within 1 h or less, and can detect 1 to 2 mg/liter. Normal urinary myoglobin concentrations are less than this.
