Observational studyEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2021
Serodiagnosis of Lyme borreliosis-is IgM in serum more harmful than helpful?
Observational study in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 33 citations in OpenAlex.
- An intervention in general practice to improve the management of Lyme borreliosis in Denmark.European journal of public health · 2022Trial
- News Fluorescence-Based Polarization Immunoassays as a Frontline Test for the Rapid Detection of Acute and Late Phase Lyme-Borreliosis Disease.Molecules (Basel, Switzerland) · 2026Article
- Dynamics of IgM and IgG responses in Lyme neuroborreliosis - a Norwegian longitudinal study.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Article
- Lyme carditis in Europe.Frontiers in microbiology · 2026Review
- Serologies in Lyme disease can be deceiving: a rare case of mycoplasma-induced figurate erythema with persistent IgM Lyme antibodies.Oxford medical case reports · 2025Article
- Article
- Evaluation of different standard and modified two-tier testing strategies for the laboratory diagnosis of lyme borreliosis in a European setting.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2024Article
- New BB0108, BB0126, BB0298, BB0323, and BB0689 Chromosomally Encoded Recombinant Proteins ofPathogens (Basel, Switzerland) · 2024Article
- Antibodies toMicrobiology spectrum · 2024Observational
- Pediatric Lyme Disease in Northern Italy: An 18-Year Single-Center Case Series.Microorganisms · 2024Article
- Epitope Mapping of BmpA and BBK32ACS infectious diseases · 2023Article
- Antibody Cross-Reactivity in Serodiagnosis of Lyme Disease.Antibodies (Basel, Switzerland) · 2023Review
- Utility ofFrontiers in cellular and infection microbiology · 2023Article
- The Performance of Nine Commercial Serological Screening Assays for the Diagnosis of Lyme Borreliosis: a Multicenter Modified Two-Gate Design Study.Microbiology spectrum · 2022Article
- Introduction of IgM testing for the diagnosis of acute Lyme borreliosis: a study of the benefits, limitations and costs.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2022Article
- Persistent Anti-Microbiology spectrum · 2021Article
- Diagnostic parameters of modified two-tier testing in European patients with early Lyme disease.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2020Article
Corrections and comments
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Authors and funding
2 authors at 1 institution in 2 countries.
Funding
Abstract
Interpretation of serological findings in suspected Lyme borreliosis (LB) may be challenging and IgM reactivities in serum are often unspecific (false positive). There is a risk for overdiagnosis of LB, inadequate use of antibiotics, and potential delay of proper diagnosis. In this study, we evaluated the diagnostic value of IgM analysis in serum and IgM antibody index (AI) in LB diagnosis. This was a retrospective observational study regarding Borrelia-specific antibodies in serum and Borrelia-specific AI in LB investigations being made during 2017 in Jönköping County, Sweden. Medical records of 610 patients with detectable anti-Borrelia antibodies in serum (IgM and/or IgG) and 15 patients with elevated Borrelia-specific AI were retrospectively scrutinized, and the compliance to current European recommendations was assessed. Among the 610 patients, only 30% were tested according to the European recommendations. Within this group of tests taken correctly, 50% of the LB diagnoses in patients with isolated IgM reactivity in serum were retrospectively assessed as incorrect (LB unlikely). Three pediatric patients with clinical and laboratory findings suggestive of Lyme neuroborreliosis (LNB) had elevated IgM AI alone. Serological testing without distinct clinical signs/symptoms consistent with LB contributes to most misdiagnoses. Isolated IgM positivity in serum shows limited clinical value and needs further assessment before being reported by the laboratory. Detection of IgM in combination with IgG antibodies in serum shows no clinical enhancement for correct LB diagnosis compared to isolated IgG positivity. However, Borrelia-specific IgM AI may be important for sensitivity in early LNB.
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