眼内炎患者伯氏疏螺旋体血清学检测解读困难。

Difficulties of interpreting Borrelia serology in patients with uveitis.

机构信息

University of Heidelberg, Interdisciplinary Uveitis Center, Department of Ophthalmology, Heidelberg, Germany.

出版信息

Ocul Immunol Inflamm. 2011 Aug;19(4):227-31. doi: 10.3109/09273948.2011.568662.

DOI:10.3109/09273948.2011.568662

PMID:21770797

Abstract

PURPOSE

We aimed to review all uveitis patients with a positive Borrelia serology to evaluate positive results in uveitis subtypes. Further we wanted to test a self-assembled Interferon gamma release assay (IGRA) as a possible supplement method in these patients.

METHODS

Patients where serology for Borrelia was ordered from September 2005 to May 2008, were identified by database search. Patients with positive results in ELISA and Western Blot were retested by a self-assembled IGRA. Bayes Theorem was applied.

RESULTS

Testing for Borrelia was ordered for 184 patients. 18 patients (9,8%) showed positive results. 11 were positive for IgG (5,9 %), 3 were positive for IgG and IgM (1,6 %) and 4 for IgM (2,1%). Applying Bayes Theorem, we calculated a posttest-probability of 9% in case of a positive test result. 16 of the 18 patients were retested by IGRA. None of them showed a positive result.

CONCLUSIONS

A positive serology with uveitis as the only clinical symptom is not sufficient to confirm Borreliosis as 5,9 % of patients with uveitis and a positive IgG serology correspond to the normal spread of Borrelia in the population. Looking at posttest-probability shows a lot of false-positive test results when testing all uveitis patients for Borrelia routinely.

摘要

目的

我们旨在回顾所有葡萄膜炎患者中血清学阳性的伯氏疏螺旋体，以评估其在葡萄膜炎各亚型中的阳性结果。此外，我们希望测试一种自组装的干扰素γ释放试验（IGRA）作为这些患者的可能补充方法。

方法

通过数据库检索，确定了 2005 年 9 月至 2008 年 5 月期间因血清学检查而订购伯氏疏螺旋体的患者。通过自组装的 IGRA 对 ELISA 和 Western Blot 检测结果阳性的患者进行了复测。应用贝叶斯定理。

结果

对 184 例患者进行了伯氏疏螺旋体检测。18 例（9.8%）结果阳性。11 例 IgG 阳性（5.9%），3 例 IgG 和 IgM 阳性（1.6%），4 例 IgM 阳性（2.1%）。应用贝叶斯定理，我们计算出在检测结果阳性的情况下，后验概率为 9%。18 例患者中有 16 例接受了 IGRA 复测。他们均未显示阳性结果。