RESUMO
The significance of reactive serlogical tests for lyme disease in patients with tropical spastic paraparesis (TSP) was assessed by examining serum samples from 128 of these patients and 200 healthy Jamaicans by lyme indirect immunofluorescent antibody (IFA), enzyme immuno-assay (EIA) and western blot analyses. Sera were also examined in serological tests for syphilis (STS), an unabsorbed fluorescent treponemal antibody test and leptospira microagglutination test. The prevalence of positive Lyme IFA and EIA results did not differ significantly between sera from TSP patients (12.5 percent and healthy controls (10.0 percent). Western blot analyses showed that the positive lyme IFA and EIA results observed in this study were due to false positive reactions. Seventy-five per cent of lyme IFA/EIS positive sera from TSP patients had treponemal antibodies. Eighty per cent of those from healthy controls were negative in standard STS but 85 percent were positive when tested in an unabsorbed fluorescent treponemal antibody (FTA). These data indicate that reactive serological tests for lyme disease in Jamaican TSP patients and healthy Jamaicans are false positive reactions due to cross-reactivity with other spirochaetes, notably treponema pallidum and non pathogenic treponemes (AU)
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Adolescente , Doença de Lyme/epidemiologia , Sorologia , Paraparesia Espástica Tropical/epidemiologia , Borrelia burgdorferi/patogenicidade , Imunofluorescência/estatística & dados numéricos , Técnicas Imunoenzimáticas/estatística & dados numéricos , Sífilis , Leptospira , Jamaica/epidemiologiaRESUMO
Lyme disease, caused by the spirochaete Borrelia burgdorfer, occurs worldwide, but has not been reported in Jamaica. Nevertheless, antibodies to B. burgdorferi have been found in sera from Jamaican patients with tropical spastic parapareisis (TSP). Lyme disease may asymptomatic. The late stages may be confused with other diseases having neurologic or arthritic features. This study was therefore undertaken to investigate the prevalence of B. burgdorferi antibodies in health Jamaicans and their significance in patients with TSP. Commercially available indirect immunofluorescence antibody (IFA), enzyme immunoassay (EIA) and Western immunoblot kits for Lyme disease were used to examine serum samples from healthy Jamaican (n=200) and TSP patients (n=128). Sera were also examined for a serological test for syphilis (STS) and for antibodies to leptospira. The prevalence of positive IFA tests and EIA for antibodies to B. burgdorferi did not differ significantly between sera from TSP patients (12.5 percent) and healthy controls (10 percent). Western immunoblot analysis showed that all sera occurred in 26.6 percent of sera from TSP patients and 15.5 percent from healthy controls. Of 16 sera from TSP patients which were positive in Lyme IFA and/or EIA, 81.2 percent had treponemal antibodies, while 80 percent of those from healthy controls were negative in STS. Leptospiral antibodies were not found in any serum tested. These data indicate that serological tests for Lyme disease are of limited value is settings such as Jamaica where there is a high prevalence of treponemal antibodies. In these circumstances, diagnostic or epidemiological studies should include Western immunoblot assays (AU)