[The significance of immunoblot tests in diagnosis of Lyme borreliosis in children]. / Znaczenie testu immunoblot w diagnostyce boreliozy z lyme u dzieci.

ABSTRACT

OBJECTIVE: Verification of Lyme disease serodiagnosis in children by use of Western blot (WB) testing. MATERIAL AND METHODS: 24 children (8 males, 16 females) at the average age of 15,5y have been diagnosed from January 1st till December 31, 2007. All Lyme patients with positive or equivocal ELISA IgM and or ELISA IgG test results were included in the study. The ELISA (Bellco Biomedica, Austria)-Western blot (DRG, Diagnostics, Germany) two test protocol using sera of Lyme borreliosis patients was evaluated. RESULTS: Positive ELISA IgM results were confirmed in 20 out of 24 children (83,3%). In WB confirmation test, the positive results were obtained in 10 children (41,7%), equivocal results--in 22 (8.3%) and negative in 12 (50%) children. The quantitative accordance of both ELISA IgM-WB IgM tests was 50%. The higher quantitative accordance (96%) of both tests was obtained studying IgG serologic response. CONCLUSION: A positive ELISA IgM result very likely represents a false-positive result and should always be confirmed by WB assay and objective clinical signs of borreliosis before implementing the appropriate antimicrobial therapy.