The predictive value of CXCL13 in suspected Lyme neuroborreliosis: a retrospective cross-sectional study

AbstractThe role of CXCL13 as a marker of Lyme neuroborreliosis (LNB) is under investigation, and CXCL13 is not part of routine diagnostics in suspicion of LNB. Our aim was to find the optimal cut-off value of CXCL13 for LNB in a Danish population and to investigate the role of CXCL13 both in early LNB and as a discriminatory marker between LNB and other neuroinflammatory disorders. We conducted a retrospective cross-sectional study including all patients with a cerebrospinal CXCL13 test performed at the Department of Clinical Immunology, Odense University Hospital, Denmark, between 1 January 2015 and 31 December 2018. We included 619 patients, of which 51 had definite LNB, 14 patients had possible LNB with neurological symptoms suggestive of LNB and pleocytosis but no intrathecalBorrelia antibodies, eight patients had prior LNB and 546 had no LNB. With an optimal CXCL13 cut-off of 49  ng/L we found a sensitivity of 100% and specificity of 94% (AUC 0.988, 95% CI 0.980–0.996) when patients treated with antibiotics prior to lumbar puncture were excluded (n = 130). All patients with possible LNB had a CXCL13 value above the cut-off value; 18/546 patients (3.3%) without LNB had a CXCL13 value ≥ 50 ng/L. While CXCL13 cannot be used as a stand-alone test, it can be used as a reliable additional marker in treatment-naive patients suspected of LNB . CXCL13 can be used to monitor treatment response in LNB patients.
Source: European Journal of Clinical Microbiology and Infectious Diseases - Category: Microbiology Source Type: research

Related Links:

Conclusions: The interleukin-6/interleukin-10 ratio can be used as a rapid diagnostic cue upon suspected tick-borne infection, enabling fast and correct treatment. Also, in serology-negative results, such information may strengthen a clinical suspicion.
Source: The Pediatric Infectious Disease Journal - Category: Infectious Diseases Tags: Translational Medicine Reports Source Type: research
Conclusions: Because serum serology can be negative at presentation, lumbar puncture is a valuable tool when diagnosing LB among children with facial palsy. Pleocytosis and increased protein and CXCL13 values in the CSF suggest LB as the cause of facial palsy.
Source: The Pediatric Infectious Disease Journal - Category: Infectious Diseases Tags: Original Studies Source Type: research
Conclusions OCB are important biomarkers that can support MRI diagnostics and help to avoid false-positive MS diagnoses. Therefore, the revised McDonalds criteria have increased the importance of the OCB. New biomarkers such as AQP4 have now established themselves in clinical practice, and others such as Anti-MOG and NfL are about to enter clinical routine. An important focus in the search for new biomarkers is the monitoring of therapy efficacy and the prediction of severe side effects. Many other CSF molecules such as CHI3L1, IL-6, or CXCL13 show potential as markers for clinical practice, but further research is nee...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
CONCLUSION: In the presence of unilateral or bilateral diaphragmatic paralysis of undetermined aetiology, it seems relevant to perform Lyme serology in the blood and, in positive cases, to follow up with a lumbar puncture in order to detect intrathecal IgG synthesis. PMID: 30711345 [PubMed - as supplied by publisher]
Source: Revue des Maladies Respiratoires - Category: Respiratory Medicine Tags: Rev Mal Respir Source Type: research
Publication date: Available online 6 December 2018Source: Ticks and Tick-borne DiseasesAuthor(s): Tereza Rojko, Petra Bogovič, Stanka Lotrič-Furlan, Katarina Ogrinc, Tjaša Cerar-Kišek, Urška Glinšek Biškup, Miroslav Petrovec, Eva Ružić-Sabljić, Andrej Kastrin, Franc StrleAbstractThe aims of the study were to determine the frequency of borrelial infection in patients with peripheral facial palsy (PFP) and to compare clinical and laboratory characteristics of patients with borrelial PFP and patients with PFP of unknown etiology.Adult patients with PFP who presented at our department be...
Source: Ticks and Tick borne Diseases - Category: Zoology Source Type: research
In this study, we analyzed FGF21 levels and alterations in the expression of genes encoding components of the FGF21-responsive molecular machinery in adipose tissue from aged individuals so as to ascertain whether altered FGF21 responsiveness that develops with aging jeopardizes human health and/or accelerates metabolic disturbances associated with aging. We studied a cohort of 28 healthy elderly individuals (≥70 years) with no overt signs of metabolic or other pathologies and compared them with a cohort of 35 young healthy controls (≤40 years). Serum FGF21 levels were significantly increased in elderly indiv...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
We present the case of a 10-year old patient from southeastern Ontario with severe bilateral facial palsy. MRI was performed that showed extensive symmetric enhancement of cervical cranial nerve roots and multiple cranial nerves (III, V, VI, VII, VIII, X and XII). Lumbar puncture was performed that revealed pleocytosis and elevated proteins in the cerebrospinal fluid. Serology confirmed the diagnosis of neuroborreliosis. The patient was treated with a 4-week course of IV ceftriaxone, following which he returned to baseline.
Source: IDCases - Category: Infectious Diseases Source Type: research
Conclusions:Our patient shows a chronological dissociation of Tolosa-Hunt clinical features but otherwise he fits ICHD-3 criteria for Tolosa-Hunt syndrome. This case teach us to think about this rare syndrome if the patient develops a typical pain after the presentation of the oftalmoplegia when other causes have been appropriately excluded and the response to corticoid therapy is rapid and complete.Disclosure: Dr. Pire has nothing to disclose. Dr. Villa has nothing to disclose. Dr. Pareja has nothing to disclose. Dr. Lillo has nothing to disclose.
Source: Neurology - Category: Neurology Authors: Tags: Headache: Epidemiology and Disease Characteristics Source Type: research
Conclusions:Diagnostic approach to bilateral FNP should evaluate for: traumatic (skull fractures), infectious (classically Lyme disease), metabolic (diabetes), autoimmune (sarcoidosis, Guillain-Barré syndrome), congenital (Moebius syndrome) and neoplastic (brainstem tumors) entities. WM is a rare cause, a condition due to low-grade B cell lymphoma where lymphoplasmacytoid cells infiltrate different tissues and secrete monoclonal IgM. Peripheral neuropathy develops in 15–30% of the cases, usually a chronic, progressive, symmetric, predominantly distal polyneuropathy. Facial nerve impairment is unusual, caused b...
Source: Neurology - Category: Neurology Authors: Tags: Neuro-oncology: Brain and CNS Metastases Source Type: research
Conclusions:By education and restricted use initiatives, inappropriate CSF Lyme PCR testing for diagnosing neuroborreliosis was significantly affected. This initiative led to reduced healthcare costs for the institution and patient while improving evidence based medical practices.Disclosure: Dr. Vanino has nothing to disclose. Dr. Baldwin has nothing to disclose.
Source: Neurology - Category: Neurology Authors: Tags: Infectious Disease: HIV, Syphilis, Borrelia, TB, Cysticercosis, and Other Infections Source Type: research
More News: Allergy & Immunology | Brain | Denmark Health | Hospitals | Infectious Diseases | Lumbar Puncture | Lyme Disease | Microbiology | Neurology | Study