Frank Dressier, MD; Natalino H. Yoshinari, MD; Allen C. Steere, MD
▪ Objective: To determine the sensitivity and specificity of the T-cell proliferative assay as a diagnostic test in Lyme disease.
▪ Design: Cross-sectional study of patients with Lyme arthritis or chronic neuroborreliosis who had a history of erythema migrans, positive antibody responses to Borrelia burgdorferi by enzyme-linked immunosorbent assay (ELISA), or both; patients with other diseases; and healthy subjects.
▪ Setting: Diagnostic Lyme disease clinic in a university hospital.
▪ Patients: Forty-two of the 67 patients with active Lyme arthritis or chronic neuroborreliosis who were seen during the study period; 16 patients with inactive late Lyme disease; 77 patients with other rheumatologic or neurologic diseases; 9 workers from the Borrelia laboratory; and 9 healthy subjects.
▪ Measurements and Main Results: Nineteen of 42 patients with Lyme arthritis or chronic neuroborreliosis and 4 of 77 patients with other diseases had positive T-cell proliferative responses to B. burgdorferi antigens. The sensitivity of the proliferative assay was 45% (95% Cl, 30% to 60%) and the specificity was 95% (95% Cl, 87% to 99%). Twelve of 27 patients with active Lyme arthritis, 7 of 15 patients with chronic neuroborreliosis, 4 of 16 patients with inactive Lyme disease, 4 of 9 healthy Borrelia laboratory workers, and 0 of 9 healthy subjects had positive responses. Three of five patients with Lyme disease who had negative or indeterminant antibody responses by ELISA had positive T-cell proliferative responses.
▪ Conclusion: The T-cell proliferative assay may be a helpful diagnostic test in the small subset of patients with late Lyme disease who have negative or indeterminant antibody responses by ELISA.
Frank Dressier, Natalino H. Yoshinari, Allen C. Steere. The T-Cell Proliferative Assay in the Diagnosis of Lyme Disease. Ann Intern Med. 1991;115:533–539. doi: 10.7326/0003-4819-115-7-533
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Published: Ann Intern Med. 1991;115(7):533-539.
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