Positive intrathecal anti-Borrelia antibody synthesis: what are the implications for clinical practice? Clinical features and outcomes of 138 patients in a French multicenter cohort study
AbstractWe aimed to describe the clinical characteristics, management, and residual symptoms (RS) in patients with definite and possible Lyme neuroborreliosis (LNB). We conducted a retrospective French multicenter cohort study (2010 –2020). Cases of LNB were defined as clinical manifestations attributed to LNB and a positiveBorrelia-specific intrathecal antibody index (AI) ( “possible” LNB) and with pleocytosis (“definite” LNB). Risk factors of RS were determined using a logistic regression model. We included 138 adult patients with a positive AI. Mean age was 59.5 years (± 14.7). The median duration of symptoms before diagnosis was 1.0 [0.5–4.0] months. T he most frequent manifestation was radicular pain (n = 79, 57%). Complete cerebrospinal fluid (CSF) leukocyte analysis was available in 131 patients, of whom 72 (55%) had pleocytosis. Patients with definite LNB had a shorter duration of symptoms (median 1.0 [0.5–2.6] vs. 3.0 [0.6–7.0] months,p < 0.01) and more radicular pain (74% vs 44%,p < 0.01) than patients with possible LNB. At the last visit (median duration of follow-up: 70 [30–175] days), 74/124 patients (59.7%) reported RS, mostly radicular pain (n = 31, 25%). In multivariate analysis, definite LNB (OR = 0.21 [0.05–0.931],p = 0.039) and duration of symptoms less than 3 months (OR = 0.04 [0.01–0.37],p = 0.005) were protective factors against RS at last follow-up. Our study highlights the challenges of...
Source: European Journal of Clinical Microbiology and Infectious Diseases - Category: Microbiology Source Type: research
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