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C6-peptide serology as diagnostic tool in neuroborreliosis

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Tjernberg I, Schön T, Ernerudh J, Wistedt AC, Forsberg P, Eliasson I. C6-peptide serology as diagnostic tool in neuroborreliosis. APMIS 2008;116:393–9.

The aim of this study was to evaluate the usefulness of borrelia serology (Quick ELISA C6 Borrelia assay kit) as a diagnostic tool in cases of suspected neuroborreliosis. A retrospective patient material consisting of 124 paired serum and cerebrospinal fluid samples with a positive anti-borrelia antibody index (AI) using the IDEIA Lyme Neuroborreliosis test was compared with 124 AI-negative matched control subjects. The patients were divided into four groups based on presence of pleocytosis and age above or below 12 years. The presence of positive C6 serology in AI-positive patients with pleocytosis was 89% (83/93), significantly different (p<0.01) from in patients without pleocytosis (58%, 18/31). In AI-positive patients aged ≥12 years with pleocytosis, 94% (51/54) had a positive C6 serology. Of AI-positive patients with a symptom duration of more than 30 days, 93% (27/29) were positive by the C6 test. We conclude that the C6 serum test, together with clinical evaluation, is a powerful diagnostic tool in adult (≥12 years) European patients with suspected neuroborreliosis with a symptom duration of more than 30 days. Patients with suspected neuroborreliosis and positive C6 results should be further investigated by lumbar puncture for definite diagnosis.
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Keywords: Lyme neuroborreliosis; cerebrospinal fluid; intrathecal antibodies; pleocytosis; serology

Document Type: Research Article

Affiliations: 1: Clinical Microbiology, Kalmar County Hospital, Kalmar 2: Division of Clinical Immunology, Unit of Autoimmunity and Immune Regulation (AIR), Department of Clinical and Experimental Medicine, University of Linköping, Linköping 3: Division of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Linköping 4: Department of Clinical Microbiology and Immunology, Lund University Hospital, Lund, Sweden

Publication date: May 1, 2008

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