![]() ![]() For all eligible children, we abstracted the following data from the medical record: demographics (age, sex), clinical presentation, and duration of symptoms. We limited our primary analysis to children who had a positive EIA followed by a positive Lyme IgM immunoblot but a negative IgG immunoblot. This laboratory used a Borrelia burgdorferi quantitative whole cell sonicate EIA, followed by reflex IgM and IgG immunoblot (MarDx Trinity Biotech, Tray, Ireland) testing for those with a positive or equivocal EIA (≥1.0) in accordance with recommended testing standards. We included multiple Lyme disease tests from the same patient over the study period.Īll serologic Lyme disease tests from the study institution were performed at a single commercial reference laboratory (ARUP National Laboratories, Salt Lake, Utah). We included individuals 21 years of age and younger who had a Lyme EIA obtained between January 1, 2007, and June 30, 2014. We identified patients serologically tested for Lyme disease through an electronic query of the institutional data warehouse. The institutional review board approved the study protocol with waiver of informed consent. We performed a retrospective cross-sectional study at Boston Children's Hospital located in a Lyme disease-endemic area (Boston, Massachusetts). To this end, we examined the clinical presentations of children from a highly endemic region with a positive IgM immunoblot alone. 2 However, the clinical significance of a positive Lyme disease IgM immunoblot result alone has not been rigorously evaluated in children. ![]() In a recent adult study, almost one-third of positive IgM immunoblots alone were obtained from adults who were unlikely to have Lyme disease. 1 IgM reactivity to at least 2 of 3 tested antigens is a biomarker of early infection and is a component of the currently recommended 2-tiered serologic testing algorithm. The current diagnostic standard for Lyme disease is performance of an enzyme immunoassay (EIA) followed by IgM and IgG immunoblots in cases of a positive or equivocal EIA. All later manifestations, however, require serologic testing to distinguish Lyme disease from other diseases with similar presentations. Localized disease, which manifests with the distinctive erythema migrans (EM) skin lesion, can be diagnosed clinically in endemic areas. Current diagnostic testing for Lyme disease lacks sensitivity during early infection.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |