Lyme disease: antibodies to borrelia in the blood
Last reviewed: 23.04.2024
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Antibodies to borrelia in serum are normal.
Lyme disease, or systemic tick-borne borreliosis, is a recurrent transmissible natural focal infection caused by the spirochete Borrelia burgdorferi (mobile gram-negative spiral-shaped bacteria).
The disease is characterized by a staged clinical picture:
- Stage 1 develops 3-33 days after the bite of an insect (tick) and is manifested by fever, erythematous migratory rash (in 85% of patients);
- Stage 2 occurs 4 weeks after the bite; In 10% of patients, cardiac pathology appears, 15% develop neurological symptoms (symptoms of aseptic meningitis, Bell's paralysis, peripheral neuropathies);
- Stage 3 develops after 6 weeks (up to several years) after a bite in 60% of untreated patients, manifested by arthritis (often regarded as juvenile rheumatoid); Reinfection may occur.
To confirm the diagnosis, ELISA is used to detect specific antibodies of classes IgM and IgG to Borrelia.
In Lyme disease, specific IgM antibodies usually appear in the blood 2-4 weeks after the onset of migratory erythema, the peak of antibodies occurs in the 6-8th week of the disease. In stage 1, IgM antibodies are detected in 40-60% of patients. In some patients, the IgM content remains elevated for many months or appears again at the end of the disease, which indicates the continuing infection and inefficiency of antibiotic therapy. The IgG antibody titer rises more slowly (4-6 weeks after erythema), the peak falls on the 4th-6th month, the titer can remain high for several months or years, even against the background of successful treatment. Almost all patients with complications of the 2 nd and 3 rd stages have a high level of IgG antibodies. A single determination of IgG antibody titer has no diagnostic value, since it may indicate a previous infection. The study of paired sera (acute phase and recovery), taken at an interval of 4-6 weeks, showing a decrease or increase in the level of IgG, indicates the recovery or presence of Lyme disease.
False positive results of IgM antibody determination are possible when a rheumatoid factor is present in the patient's blood, and a high IgG antibody titer can be caused by antibodies in diseases caused by spirochaetes (for example, syphilis); low IgG antibody titer is possible with infectious mononucleosis, viral hepatitis B, rheumatic diseases (SLE), periodontal diseases, in 5-15% of healthy persons from the epidemic zone.
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