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The recomBead Borrelia antibody index, CXCL13 and total IgM index for laboratory diagnosis of Lyme neuroborreliosis in children
Uppsala University, Sweden.
Regional Jonköping County, Sweden.
Regional Jonköping County, Sweden.
Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Kalmar County Council, Sweden.
2017 (English)In: European Journal of Clinical Microbiology and Infectious Diseases, ISSN 0934-9723, E-ISSN 1435-4373, Vol. 36, no 11, 2221-2229 p.Article in journal (Refereed) Published
Abstract [en]

For laboratory diagnostics of Lyme neuroborreliosis (LNB), the recomBead Borrelia antibody index (AI) assay has shown promising results in a mixed age population, but has not previously been evaluated with specific focus on paediatric patients. The aim of the study was to evaluate the recomBead Borrelia AI assay in cerebrospinal fluid (CSF) for the laboratory diagnosis of LNB in children. We also wanted to explore whether early markers, such as CXCL13 in CSF and/or total IgM index could be useful as complementary diagnostic tools. Children being evaluated for LNB in a Swedish Lyme endemic area were included in the study (n = 146). Serum and CSF were collected on admission. Patients with other specific diagnoses were controls (n = 15). The recomBead Borrelia AI assay and the recomBead CXCL13 assay (Mikrogen) were applied together with total IgM index. The overall sensitivity for recomBead Borrelia AI (IgM and IgG together) was 74% and the specificity was 97%. However, the highest sensitivity (91%) at an acceptable level of specificity (90%) was obtained by recomBead Borrelia AI together with CXCL13 and total IgM index, showing a positive predictive value of 84% and a negative predictive value of 95%. Thus, the recomBead Borrelia AI assay performs with moderate sensitivity and high specificity in paediatric LNB patients. The major advantage seems to be increased sensitivity in the possible LNB group compared to the IDEIA assay. The diagnostic sensitivity may be further increased by using a combination of early markers, such as CXCL13 in CSF and total IgM index.

Place, publisher, year, edition, pages
SPRINGER , 2017. Vol. 36, no 11, 2221-2229 p.
National Category
Pediatrics
Identifiers
URN: urn:nbn:se:liu:diva-142971DOI: 10.1007/s10096-017-3049-xISI: 000413620200028PubMedID: 28730535OAI: oai:DiVA.org:liu-142971DiVA: diva2:1156565
Note

Funding Agencies|Regional Research Council Uppsala-Orebro [RFR-226161, RFR-462701]; Center for Clinical Research Dalarna-Uppsala University [CKFUU-105141, CKFUU-374651, CKFUU-566761]; Swedish Society of Medicine [SLS-498901, SLS-93191]; Division of Medical Diagnostics, Region Jonkoping County; ScandTick Innovation, an EU Interreg project

Available from: 2017-11-13 Created: 2017-11-13 Last updated: 2017-12-07

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