Smith J L, Crumpton B C, Hummer J
Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami School of Medicine, Florida.
J Clin Neuroophthalmol. 1990 Dec;10(4):255-60.
Serologic screening of patients for Lyme borreliosis began at the Bascom Palmer Eye Institute (BPEI) in September 1987. This report reviews the data on 641 sera from that date up to January 1, 1990. Initially only immunofluorescent (IFA) IgG and IgM titers were obtained. Because of increasing numbers of borderline and positive IFA tests, a Lyme enzyme linked immunosorbent assay (ELISA) was added in April 1988. Also, because of significant serologic cross reactivity in patients exposed to Treponema pallidum, rapid plasma reagin (RPR) and fluorescent treponemal antibody absorption (FTA-ABS) tests were added to the serologic screening panel. Of all sera tested, 10% showed reactive RPR tests and 22% showed reactive FTA-ABS tests. Lyme IFA IgG titers were greater than or equal to 1:64 in 17% of the sera, and Lyme ELISA tests were greater than 1.25 in 15% of the sera. Our experience agrees with reports that serum RPR or VDRL tests are nonreactive in Lyme borreliosis, and that false positive FTA-ABS tests can occur in Lyme borreliosis. The importance of getting all four tests--RPR, FTA-ABS, Lyme IFA IgG and IgM, and Lyme ELISA--in all patients suspected of spirochetal disease is emphasized.
1987年9月，巴斯科姆·帕尔默眼科研究所（BPEI）开始对患者进行莱姆病螺旋体病的血清学筛查。本报告回顾了从该日期至1990年1月1日期间641份血清的数据。最初仅获得免疫荧光（IFA）IgG和IgM滴度。由于IFA检测中临界和阳性结果的数量不断增加，1988年4月增加了莱姆病酶联免疫吸附测定（ELISA）。此外，由于梅毒螺旋体暴露患者存在显著的血清学交叉反应，快速血浆反应素（RPR）和荧光密螺旋体抗体吸收（FTA-ABS）检测被添加到血清学筛查项目中。在所有检测的血清中，10%的RPR检测呈阳性，22%的FTA-ABS检测呈阳性。17%的血清中莱姆病IFA IgG滴度大于或等于1:64，15%的血清中莱姆病ELISA检测值大于1.25。我们的经验与报告一致，即血清RPR或VDRL检测在莱姆病螺旋体病中无反应，且莱姆病螺旋体病中可能出现FTA-ABS检测假阳性。强调了对所有疑似螺旋体病患者进行RPR、FTA-ABS、莱姆病IFA IgG和IgM以及莱姆病ELISA这四项检测的重要性。
