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[False positive serological tests for Borrelia burgdorferi in patients with primary antiphospholipid syndrome]
A Selva O'Callaghan1, J Ordi Ros, J M Porcel Pérez
1Servicio de Medicina Interna, Hospital General Vall d'Hebron, Barcelona.
Abstract:
Serological tests for Borrelia burgdorferi were carried out in a series of 27 patients with primary antiphospholipid syndrome (PAPLS). The results showed a 14% prevalence of false positive Lyme disease serology in this patient population. In patients with PAPLS and false positive serologic tests for Borrelia burgdorferi neurological involvement was significantly more common (p = 0.012, Fisher's exact test) than in patients with PAPLS without that finding. We insist on the possibility that patients with PAPLS may have false positive serological tests for Borrelia burgdorferi as measured by IFI with the resulting diagnostic error. In these cases, confirmation by other techniques such as ELISA or immunoblotting is recommended.
Insights
Primary antiphospholipid syndrome (PAPLS) patients show a 14% false positive rate for Lyme disease serology. This can lead to diagnostic errors, especially with neurological symptoms, necessitating confirmatory testing.
Area of Science:
- Medical diagnostics
- Immunology
- Rheumatology
Background:
- Primary antiphospholipid syndrome (PAPLS) is an autoimmune disorder.
- Accurate serological testing is crucial for diagnosing infectious and autoimmune diseases.
- Borrelia burgdorferi causes Lyme disease, diagnosed via serology.
Observation:
- Serological tests for Borrelia burgdorferi were performed on 27 PAPLS patients.
- A 14% prevalence of false positive Lyme disease serology was observed in this cohort.
Findings:
- Patients with PAPLS and false positive Borrelia burgdorferi serology had significantly more neurological involvement (p = 0.012).
- Indirect Immunofluorescence Assay (IFI) may yield false positives for Borrelia burgdorferi in PAPLS patients.
Implications:
- False positive Lyme disease serology in PAPLS patients can cause diagnostic errors.
- Confirmatory testing using ELISA or immunoblotting is recommended for PAPLS patients with positive Lyme serology.
- This highlights the importance of considering alternative diagnoses and using multiple testing methods in complex autoimmune cases.