SynthesisEuropean journal of neurology2026
Borrelia Infections Under B Cell-Depleting Therapies: A Systematic Review of Diagnostic Challenges and Outcomes With Special Focus on Neurological Forms.
Synthesis in European journal of neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
What it found
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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
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
- Borrelia Infections Under B Cell-Depleting Therapies: A Systematic Review of Diagnostic Challenges and Outcomes With Special Focus on Neurological Forms.European journal of neurology · 2026Pooled it
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
Abstract
contextB-cell-depleting therapies such as rituximab and newer anti-CD20 agents may impair humoral immune responses and reduce the reliability of serological testing. This systematic review aims to summarize reported cases of Lyme borreliosis and relapsing fever (RF) Borrelia infections in patients receiving B-cell-depleting therapies, focusing on clinical manifestations, diagnostic challenges, and treatment outcomes.
methodsA systematic literature search was conducted using PubMed and the Web of Science Core Collection employing search terms linking B-cell-depleting therapies to Lyme borreliosis and to RF Borrelia infections.
resultsThe most reported cases in the literature were neurological infections due to Borrelia; there were 11 cases of Lyme neuroborreliosis and 8 cases of neurological infections due to B. miyamotoi reported. Lyme neuroborreliosis cases all exhibited negative serology. Pleocytosis of cerebrospinal fluid (CSF) was, however, always present, and PCR could confirm the diagnosis in 8 cases. Diagnosis in all B. miyamotoi cases relied exclusively on direct detection methods. All patients responded to standard antibiotic regimens, although persistent symptoms were reported in some cases. The other infections were 7 erythema migrans (EM), 4 disseminated Lyme borreliosis, and 3 cases of relapsing fever.
conclusionNeurological Borrelia infections may be underrecognized in patients on B cell-depleting therapies due to atypical presentations and negative serologies. Early consideration of direct diagnostic methods such as PCR or indirect methods such as CSF CXCL13 levels is critical. Neurologists should maintain a high index of suspicion for Borrelia infections in immunocompromised patients presenting with CSF pleocytosis and neurological symptoms.
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