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首页> 外文期刊>Journal of neurology >Quantitative serological antibody testing for suspected neuroborreliosis
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Quantitative serological antibody testing for suspected neuroborreliosis

机译：定量血清学抗体检测疑似神经细胞症

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Objective To assess the importance of serum IgG/IgM antibody titers for the differentiation of Lyme neuroborreliosis (LNB) from its mimics. Method This was a retrospective, cross-sectional study conducted at two German neurological centers. Serological parameters (ELISA or CLIA analysis) and clinical presentation of 28 patients with definite LNB were compared to those of 36 patients with neurological symptoms mimicking LNB (mimics). Analysis was performed using receiver operating characteristic (ROC) and binary logistic regression. Results Elevated IgG-titers had a high sensitivity for neuroborreliosis in both centers (0.95 and 1.0). The optimal cutoff-values were set to 26.35 in center A (ELISA), and 64.0 in center B (CLIA). Diagnostic specificity was 0.41 and 0.89 in this constellation. Elevated IgM-titers showed a high diagnostic specificity for a cutoff at 68.10 (A) and 47.95 (B) (0.93 and 0.89). Sensitivity was 0.45 and 0.5. Overall diagnostic accuracy was low in both centers (A: IgG AUC = 0.665, IgM AUC = 0.629; B: IgG AUC = 0.917, IgM AUC = 0.556). In logistic regression of antibody titers and clinical measures, prediction of LNB was significantly better than the "null hypothesis". Clinical measures showed the highest odds ratio. Conclusion Data show that in addition to the clinical presentation of patients with symptoms suggesting central or peripheral nervous system manifestation, serum IgG- and IgM-titers help to identify LNB-patients. The results should guide physicians counseling patients with suspected LNB about further diagnostic steps and treatment.
机译：目的评估血清IgG / IgM抗体滴度的重要性，以与其模拟的莱姆神经源症（LNB）分化。方法这是在两个德国神经学中心进行的回顾性的横截面研究。血清学参数（ELISA或CLIA分析）和28例明确LNB患者的临床介绍与36例神经系统症状模仿LNB（模拟）的患者。使用接收器操作特征（ROC）和二进制逻辑回归来执行分析。结果升高的IgG滴度对两个中心（0.95和1.0）中的神经细胞源性具有很高的灵敏度。最佳截止值在中心A（ELISA）中设定为26.35，并在中心B（CLIA）中的64.0。该星座中的诊断特异性为0.41和0.89。升高的IgM滴度显示出68.10（a）和47.95（b）（0.93和0.89）的截止值的高诊断特异性。敏感度为0.45和0.5。两个中心的整体诊断精度低（A：IgG AUC = 0.665，IgM AUC = 0.629; B：IgG AUC = 0.917，IGM AUC = 0.556）。在抗体滴度和临床措施的逻辑回归中，LNB的预测明显优于“零假设”。临床措施显示出最高的差距。结论数据显示，除了症状患者的临床介绍外，表明中环或外周神经系统表现，血清IgG-和IgM滴度有助于鉴定LNB患者。结果应引导医生咨询患者疑似LNB关于进一步诊断步骤和治疗。

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