Persistent IgM antibodies were specific for the C-terminal PKKP motif of OspC. Nonspecific symptoms improved significantly more often in patients with lower IgM ELISA results. The mean ELISA value in the study group was dependent on time elapsed since past EM. The mean IgM-ELISA values did not change significantly during follow-up (median 6.2 months). Fifty-nine patients (46 women 78%) were included in the study group. Further, we investigated the cross-reactivity with Borrelia-unrelated proteins. burgdorferi sl was examined by immunoblotting. Specificity of IgM antibodies for outer surface protein C (OspC) of B. The association between persistent IgM and nonspecific symptoms was evaluated statistically. Previous antibiotic treatments were assessed. The relation between ELISA values and time elapsed since past erythema migrans (EM) was analyzed. The study group comprised individuals with persistent IgM antibodies in the absence of IgG. Lyme Disease IgM IFA Test System kit insert.The aim of the study was to investigate the etiology of persistent IgM antibodies against Borrelia burgdorferi sensu lato (sl) and to analyze their association with nonspecific symptoms. Additional cross reactivity has been reported in Leptospirosis, Infectious Mononucleosis and SLE. Both IgM and IgG titres can remain positive for many months or years.Ĭross-reactivity with other pathogenic spirochetal diseases such as Syphilis has been reported. Patients with Lyme Disease produce antibodies of the IgM class during the first four weeks after the onset of EM and produce IgG antibodies more slowly. Serological methods are the most common methods of choice. Direct culture methods cannot be relied upon in the diagnosis of Lyme Disease due to competing microflora, complicated growth requirement and the slow growth rate of the spirochete. The arthritic attacks may occur for month or years.ĭirect culture from the EM site has been reported, as well as isolation from blood and spinal fluid. Other symptoms include mood swings, loss of memory, inability to concentrate and poor motor co-ordination. Generally the large joints are affected with pain and swelling. Dizziness, weakness, irregular heartbeat, Meningitis and inflamed nerve roots in the neck are general symptoms of Stage II.Īrthritic symptoms. These symptoms may appear from weeks to months following Stage I. Neurological, cardiac and musculoskeletal involvement. During this period, symptoms of headache, malaise, myalgia, fever, arthralgia, fatigue and lymphadenopathy are usually present. The clinical progression of the disease can be divided into three stages:ĮM may develop within a few days to weeks following a tick bite. The following are symptoms of Lyme Disease:Ī red lesion near the site of the tick bite is called erythema Migrans (EM). Patients with very early stage Lyme disease may test negative, because IgM antibodies may not have reached detectable levels.Īntibiotic therapy given early in the disease may prevent the development of an antibody response.Īll test results must be considered in conjunction with the clinical picture presented by the patient. In Lyme disease the VDRL and RPR are generally negative. In active syphilis the VDRL or RPR are positive. As well as patients with mononucleosis (EBV), lupus erythematosis, and rheumatoid arthritis.Īlthough the clinical picture of Lyme disease is quite different from that of active syphilis, an easy means of differentiating these two diseases is by the use of the VDRL or RPR tests. The disease generally occurs in stages, however, the early stages of the illness may be asymptomatic and the patient may present with late manifestations.įalse positive results occur in patients with other pathogenic spirochetal diseases such as syphilis, yaws, pinta, leptospirosis, and relapsing fever. B.burgdorferi was first isolated from the Ixodes dammini tick. The disease is transmitted by a tick which lives on animals such as deer, wild mice, birds, racoons, horses, dogs and cats. The disease has been documented in Europe and more recently in the United States during an epidemic in Old Lyme, Connecticut, in 1975. Lyme Disease is caused by the spirochete Borrelia burgdorferi. Reporting of results for both IgG and IgM assays is qualitative. The LIA is considered a confirmatory assay and, as such specimen referral to other testing sites will not be provided. The LIA uses recombinant antigens (VlsE for IgG and OspC for IgM) and can detect both USA and European strains of Borrelia. Patient requests are tested in a batch size of 6Įuroimmun EUROLINE Line Immunoassay (LIA). Turnaround Time: Between 3 weeks and 6 weeks DISCLAIMER: This link was displayed at 11:32:06 and expires on if printed.
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