Association of HLA-DR2 antigen with serum IgG antibodies against Borrelia burgdorferi in Bannwarth's syndrome.
The frequency of the HLA-DR2 antigen in 33 patients with clinical symptoms and signs of Bannwarth's syndrome was 33%, which was not significantly different from the 29% occurrence in 505 control subjects. However, all 11 HLA-DR2-positive patients had elevated serum levels of IgG antibodies against Borrelia burgdorferi, and these were present in 45% of 22 HLA-DR2-negative patients (P = 0.004). In the 21 patients with anti-B. burgdorferi antibodies the frequency of HLA-DR2 was 52%, which is significantly higher than the frequency in the control group (P = 0.04). The diagnosis of Bannwarth's syndrome was serologically confirmed by a positive indirect immunofluorescence assay (IFA). A negative test result does not exclude the diagnosis, as has recently been demonstrated with more sensitive techniques. The association between HLA-DR2 and a positive IFA suggests that the IFA selects a subgroup of patients with Bannwarth's syndrome and a different immune response. We could not demonstrate differences in the clinical spectrum and outcome between the two groups.
Wokke
J H
JH
University Department of Neurology, Academic Hospital Utrecht, The Netherlands.
van Doorn
P A
PA
Brand
A
A
Schreuder
G M
GM
Vermeulen
M
M
D000907:Antibodies, Bacterial / Q000276:immunology*; D000936:Antigen-Antibody Complex / Q000032:analysis*; D001898:Borrelia / Q000276:immunology; D001899:Borrelia Infections / Q000276:immunology*; D006684:HLA-DR Antigens / Q000276:immunology*; D015802:HLA-DR2 Antigen; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology*; D008193:Lyme Disease / Q000276:immunology*; D008875:Middle Aged; D013577:Syndrome
D000907:Antibodies, Bacterial; D000936:Antigen-Antibody Complex; D006684:HLA-DR Antigens; D015802:HLA-DR2 Antigen; D007074:Immunoglobulin G