First name
Paul
Middle name
M
Last name
Lantos

Title

Two-Tier Lyme Disease Serology in Children with Previous Lyme Disease.

Year of Publication

2021

Number of Pages

Date Published

2021 Oct 04

ISSN Number

1557-7759

Abstract

<p>A history of Lyme disease can complicate the interpretation of Lyme disease serology in acutely symptomatic patients. We prospectively enrolled children undergoing evaluation for Lyme disease in the emergency department of one of eight participating Pedi Lyme Net centers. We selected symptomatic children with a Lyme disease history (definite, probable, or none) as well as an available research biosample. We defined a Lyme disease case with either an erythema migrans (EM) lesion or positive two-tier serology with compatible symptoms. Using a generalized estimating equation, we examined the relationship between time from previous Lyme disease diagnosis and current Lyme disease after adjustment for patient demographics and symptoms as well as clustering by center. Of 2501 prospectively enrolled study patients, 126 (5.0%) reported a history of definite or probable Lyme disease. Of these children with previous Lyme disease, 47 met diagnostic criteria for Lyme disease at the time of enrollment (37.3%; 95% confidence interval [CI] 29.1-45.7%); 2 had an EM lesion, and 45 had positive two-tier Lyme disease serology. Over time from the previous Lyme disease diagnosis, the less likely the patient met diagnostic criteria for Lyme disease (adjusted odds ratio 0.62 per time period; 95% CI 0.46-0.84). For children with a history of Lyme disease before enrollment, one-third met the diagnostic criteria for acute Lyme disease with a declining rate over time from previous Lyme disease diagnosis. Novel Lyme disease diagnostics are needed to help distinguish acute from previous Lyme disease.</p>

DOI

10.1089/vbz.2021.0030

Alternate Title

Vector Borne Zoonotic Dis

PMID

34610255
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Title

Positive Two-tiered Lyme Disease Serology is Uncommon in Asymptomatic Children Living in Endemic Areas of the U.S.

Year of Publication

2018

Number of Pages

Date Published

2018 Jul 31

ISSN Number

1532-0987

Abstract

<p>Knowing the frequency of positive Lyme disease serology in children without signs of infection facilitates test interpretation. Of 315 asymptomatic children from Lyme disease endemic regions, 32 had positive or equivocal C6 enzyme linked immunoassays, but only 5 had positive IgG or IgM supplemental immunoblots (1.6%, 95% confidence interval 0.7-3.7%).</p>

DOI

10.1097/INF.0000000000002157

Alternate Title

Pediatr. Infect. Dis. J.

PMID

30067595
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