Evidence map›Paper›PMID 41896937›Full record

ArticleJournal of medical case reports2026

Definite neuroborreliosis with atypical antibody-profiles: a case report.

Ingerid Skarstein, Anne Marit Solheim, Hanne Quarsten, Unn Ljøstad, Åse Mygland, Åslaug Rudjord Lorentzen, Randi Eikeland, Harald Reiso, Steffan Daniel Bos, Elling Ulvestad

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PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of medical case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Ingerid Skarstein *Haukeland University Hostpial, Department of Microbiology, P. O. Box 1400, 5021, Bergen, Norway. st03409@uib.no.ORCID http://orcid.org/0009-0006-3221-3643
Anne Marit Solheim *Department of Neurology, Sørlandet Hospital Trust, Kristiansand, Norway.ORCID http://orcid.org/0000-0001-7357-6287
Hanne QuarstenDepartment of Microbiology, Sørlandet Hospital Trust, Kristiansand, Norway.ORCID http://orcid.org/0000-0001-6469-525X
Unn LjøstadDepartment of Neurology, Sørlandet Hospital Trust, Kristiansand, Norway.ORCID http://orcid.org/0000-0002-7666-1396
Åse MyglandDepartment of Neurology, Sørlandet Hospital Trust, Kristiansand, Norway.ORCID http://orcid.org/0000-0001-9160-2805
Åslaug Rudjord LorentzenDepartment of Neurology, Sørlandet Hospital Trust, Kristiansand, Norway.ORCID http://orcid.org/0000-0002-6918-4157
Randi EikelandNorwegian National Advisory Unit on Tick-Borne Diseases, Sørlandet Hospital Trust, Kristiansand, Norway.ORCID http://orcid.org/0000-0003-0104-9626
Harald ReisoNorwegian National Advisory Unit on Tick-Borne Diseases, Sørlandet Hospital Trust, Kristiansand, Norway.ORCID http://orcid.org/0000-0003-4874-8707
Steffan Daniel BosHaukeland University Hostpial, Department of Microbiology, P. O. Box 1400, 5021, Bergen, Norway.ORCID http://orcid.org/0000-0002-2975-7520
Elling UlvestadHaukeland University Hostpial, Department of Microbiology, P. O. Box 1400, 5021, Bergen, Norway.ORCID http://orcid.org/0000-0001-5901-8422

Funding

Norwegian Multiregional Health authorities 2015/113Norwegian Multiregional Health Authorities 2015/1560
6 · The paper itself

Abstract

backgroundAccording to European Academy of Neurology guidelines, a positive Borrelia burgdorferi antibody index is required for diagnosing definite Lyme neuroborreliosis. Exceptions to the typical antibody production may be seen in the earlier phases of Lyme neuroborreliosis and in immunocompromised patients with Lyme neuroborreliosis, which can present diagnostic challenges. CASE PRESENTATIONS: We present four Norwegian immunocompetent patients (three male patients aged 52, 61 and 64 years old and one female patient aged 52 years) with neurological symptoms typical of Lyme neuroborreliosis and pleocytosis but a negative or incalculable Borrelia burgdorferi antibody index. A positive PCR for Borrelia burgdorferi DNA in cerebrospinal fluid confirmed the diagnosis of Lyme neuroborreliosis for all four patients.

conclusionOur cases demonstrate that Lyme neuroborreliosis patients with symptom duration for several weeks and a well-functioning immune system can present with atypical antibody profiles. Consequently, we suggest that in cases with pleocytosis and symptoms compatible with Lyme neuroborreliosis but negative Borrelia burgdorferi antibody index, one should consider supplementary laboratory testing to confirm the diagnosis.

Indexed as

Antibodies, BacterialBorrelia burgdorferiLyme NeuroborreliosisAnti-Bacterial AgentsDNA, BacterialFemaleHumansLeukocytosisMaleMiddle AgedNorwayPolymerase Chain ReactionTreatment OutcomeAnti-Bacterial AgentsAntibodies, BacterialDNA, BacterialBorreliaClinical neurologyLyme neuroborreliosisNeuroimmunologyNeuroinfection

Identifiers

PMID41896937
PMCPMC13151346

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