A comparative study of western blot interpretation criteria for Lyme disease serological diagnosis in our environment

Abstract

We have studied the WB reliability for the Lyme disease (LD) serological diagnosis. Twenty five samples (20 sera and 5 CSF) from 5 patients with LD, according to CDC criteria were analyzed. The syphilis was excluded in every patient. Borrelia burgdorferi antibodies were assessed by an indirect ELISA (IgG + IgM, B31 strain). Intrathecal antibodies in CSF were studied in patients with neurological diseases. Positive samples by ELISA were reanalyzed by WB according to the manufacturer, Tilton and Dressler criteria and presence either 93, 39, 34 or 23 kDa band for IgG. Four patients were controlled and one of them (25%) became negative the antibodies (serorreversion). Three of them, who had neurological symptoms, displayed intrathecal antibodies. WB sensibility for LD according to the manufacturer, Tilton, Dressler and any of the four IgG bands was 26.31%, 42.1%, 21% and 84% for IgG and 52.6%, 47.3% and 42.1% for IgM respectively. Tilton and Dressler criteria may not be as sensible as 93, 39, 34 or 23 kDa IgG bands for the diagnosis of LD in our environment.