title: The T-cell proliferative assay in the diagnosis of Lyme disease.
abstract: OBJECTIVE
  To determine the sensitivity and specificity of the T-cell proliferative assay as a diagnostic test in Lyme disease.
  
  
  METHODS
  Cross-sectional study of patients with Lyme arthritis or chronic neuroborreliosis who had a history of erythema migrans, positive antibody responses to Borrelia burgdorferi by enzyme-linked immunosorbent assay (ELISA), or both; patients with other diseases; and healthy subjects.
  
  
  METHODS
  Diagnostic Lyme disease clinic in a university hospital.
  
  
  METHODS
  Forty-two of the 67 patients with active Lyme arthritis or chronic neuroborreliosis who were seen during the study period; 16 patients with inactive late Lyme disease; 77 patients with other rheumatologic or neurologic diseases; 9 workers from the Borrelia laboratory; and 9 healthy subjects.
  
  
  RESULTS
  Nineteen of 42 patients with Lyme arthritis or chronic neuroborreliosis and 4 of 77 patients with other diseases had positive T-cell proliferative responses to B. burgdorferi antigens. The sensitivity of the proliferative assay was 45% (95% Cl, 30% to 60%) and the specificity was 95% (95% Cl, 87% to 99%). Twelve of 27 patients with active Lyme arthritis, 7 of 15 patients with chronic neuroborreliosis, 4 of 16 patients with inactive Lyme disease, 4 of 9 healthy Borrelia laboratory workers, and 0 of 9 healthy subjects had positive responses. Three of five patients with Lyme disease who had negative or indeterminant antibody responses by ELISA had positive T-cell proliferative responses.
  
  
  CONCLUSIONS
  The T-cell proliferative assay may be a helpful diagnostic test in the small subset of patients with late Lyme disease who have negative or indeterminant antibody responses by ELISA.
authors.affiliation: Tufts University School of Medicine, New England Medical Center, Boston, Massachusetts.
authors.forename: F
authors.initials: F
authors.lastname: Dressler
authors.forename: N H
authors.initials: NH
authors.lastname: Yoshinari
authors.forename: A C
authors.initials: AC
authors.lastname: Steere
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000942:Antigens, Bacterial / Q000097:blood / Q000276:immunology*; D015748:Borrelia burgdorferi Group / Q000276:immunology*; D002648:Child; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008193:Lyme Disease / Q000175:diagnosis* / Q000276:immunology; D008213:Lymphocyte Activation / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011863:Radioimmunoassay / Q000379:methods; D012680:Sensitivity and Specificity; D013601:T-Lymphocytes / Q000276:immunology*
chemical_list: D000942:Antigens, Bacterial