title: Prevalence of antibodies to Borrelia burgdorferi in serum and cerebrospinal fluid samples from patients with neurological disorders in Berlin.
abstract: Paired serum and cerebrospinal fluid (CSF) samples from 800 patients of a neurological department were tested for antibodies to Borrelia burgdorferi. A flagellum enzyme-linked immunosorbent assay was used for antibody screening. All serum/CSF pairs with any elevated antibody response were also tested by Western blotting a method for confirmation. 65 patients (8.1%) had serum IgG antibodies in ELISA and 22 of these patients (2.8%) were confirmed by Western blot. 20 patients (2.5%) had elevated antibody titres in CSF by ELISA and 12 (1.5%) reacted in the Western blot. Clinical features of Bannwarth's syndrome were present in 12 patients (1.5%) and 4 patients (0.5%) showed other manifestations of Lyme borreliosis. All patients with Bannwarth's syndrome were seropositive by both methods and 10 had elevated antibody activity in the CSF proved by the two methods. The combination of a sensitive ELISA for screening and a sensitive and specific Western blot for confirmation reduced the number of false positive results but kept its standard in detecting antibodies in patients with active disease.
authors.affiliation: Department of Neurology, Klinikum Rudolf Virchow, Freie Universität, Berlin, Germany.
authors.forename: H W
authors.initials: HW
authors.lastname: Kölmel
authors.forename: P
authors.initials: P
authors.lastname: Neumann
authors.forename: T
authors.initials: T
authors.lastname: Schneider
authors.forename: L
authors.initials: L
authors.lastname: Barnick
authors.forename: R
authors.initials: R
authors.lastname: Lange
mesh_terms: D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood* / Q000134:cerebrospinal fluid; D001604:Berlin; D015748:Borrelia burgdorferi Group / Q000276:immunology*; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D008193:Lyme Disease / Q000175:diagnosis* / Q000276:immunology; D009422:Nervous System Diseases / Q000175:diagnosis* / Q000276:immunology
chemical_list: D000907:Antibodies, Bacterial; D007074:Immunoglobulin G; D007075:Immunoglobulin M