Central Laboratory
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General information:

Serological test to prove early Borrelia infection. This class of antibodies (Borrelia burgdorferi IgM) is established after the second week of the appearance of erythema migrans (peak values from the third week). It is important that a negative single result does not reject the diagnosis and the history, clinical symptoms, as well as proven Borrelia in the tick removed from the patient should be taken into account. Monitoring of antibodies (in addition to Borrelia burgdorferi IgG) after the initial examination and 3-6 weeks later is also recommended. Early administration of antibiotics suppresses antibody formation. Serological diagnostics for antibodies of class Ig G (Borrelia burgdorferi IgG) to the causative agent of Lyme borreliosis. Their synthesis begins 2-3 months after infection and persists for a long time. The persistence of high levels is directly related to the duration and spread of the causative agent in the body. The test is important in cases of Lyme arthritis, chronic atrophic acrodermatitis, neuroborreliosis, because these antibodies persist for a long time and in a significant titer, unlike Borrelia burgdorferi IgM, which decrease over time. This class of specific antibodies is also important in cases of Lyme carditis, as well as their dynamics during treatment (a decline is expected). An important clarification is that in cases of neuroborreliosis, antibodies are mainly detected in the cerebrospinal fluid, not in the serum. Lyme borreliosis is an infectious disease caused by spiral-shaped bacteria from the Borrelia burgdorferi sensu lato complex and transmitted by the bite of an infected tick. Lyme disease is a multisystem disease that primarily affects the skin, joints, nervous system, and heart, and to a lesser extent the eyes, kidneys, and liver. The disease is considered the most common arthropod-borne infection in the temperate climate zone of the Northern Hemisphere. Cases are proven in Europe, Asia, USA and Canada. In Europe (including Bulgaria), the main carrier of Borrelia burgdorferi is the Ixodes ricin us tick. Hosts for ticks are rodents, as well as large mammals such as sheep, horses, cows. Another condition is the presence of suitable vegetation - forest massifs, high humidity. For Bulgaria, they show two peaks of maximum activity - one in spring and a second, smaller one in autumn.
There are three stages in the development of the disease:
  • early localized infection -
  • early disseminated
  • late Lyme disease

Important for the first stages is the development around the bite site of the typical erythema migrans (reddening of the skin with an oval shape of 30-50 cm). Appears between 10-15 days after the bite. Mild flu-like symptoms, shooting pains along the course of the nerves, pain in the joints and muscles, transient disturbances in heart activity are possible. During the stage of early disseminated Lyme disease, the causative agent spreads through the blood and lymphatic system. Weeks or months after its onset, the disease appears with multiple lesions (rash), with arthritis, endo- or myocarditis, neuritis, meningitis, encephalitis. Months and even years after initial infection and lack of adequate treatment, the third stage of the disease - late Lyme borreliosis - develops. Acute arthritis becomes chronic and leads to severe ankylosis of the joint. A lesion typical of the disease develops - chronic acrodermatitis progressing to skin sclerosis and atrophy. The nervous system is affected and progresses to chronic encephalopathy as a result of chronic meningoencephalitis. Clinical examination, timely diagnosis and treatment are important to stop the infection in its initial stage. Etiological treatment includes an antibiotic course, which initially leads to a complete recovery of the patient. Left untreated, the disease shows a spontaneous reverse development, but there is a danger of persistence of the causative agent and progression of the disease. With laboratory proof of the causative agent, antibiotic treatment is mandatory! In one third of the patients, there is no history of a tick bite, but erythema is found! Two-thirds of patients with chronic forms (arthritis, neuritis) also do not report a bite in the past! For this reason, laboratory diagnostics is essential!

Venous blood

Key words:

lyme disease IgM + IgG

 

 

 

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