Sibony 2005: Reactive lyme serology in optic neuritis.

CaliforniaLyme · medicine forum Guru Joined: 28 Apr 2005 Posts: 2066

Wasn't there someone on this group named Sibonie>?! (sp>?!)
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1: J Neuroophthalmol. 2005 Jun;25(2):71-82. Related Articles, Links

Reactive lyme serology in optic neuritis.

Sibony P, Halperin J, Coyle PK, Patel K.

Department of Ophthalmology and Neurology (PS, PKC, KP), State
University of New York at Stony Brook and the Department of Neurology
at North Shore University Hospital (JH), Manhasset, New York.

BACKGROUND:: Establishing a causal relationship between optic neuritis
and Lyme disease (LD) has been hampered by technical limitations in
serologic diagnosis of LD. Even so, there is a general impression that
optic neuritis is a common manifestation of LD. METHODS:: Retrospective
case analysis of Lyme serology in 440 patients with optic neuritis
examined between 1993 and 2003 in a single neuro-ophthalmic practice at
Stony Brook University Medical Center, Suffolk County, New York, a
region hyper-endemic for LD. RESULTS:: Lyme enzyme-linked immunosorbent
assay (ELISA) was positive in 28 (6.4%) patients with optic neuritis,
three of whom had syphilis with cross-reactive antibodies. Among the
remaining 25 ELISA-positive patients, optic neuritis could be
confidently attributed to LD in only one case, a patient with
papillitis. The other 24 cases had reactive Lyme serologies related to
a history of LD years earlier, asymptomatic exposure, false-positive
results, or non-specific humoral expansion. The ELISA in these 24 cases
were weakly positive and the Western blots were negative by Centers for
Disease Control criteria. There were no significant clinical
differences between the 25 seropositive optic neuritis cases and 50
seronegative optic neuritis cases. CONCLUSIONS:: Based on these cases
and a review of the literature, there is insufficient evidence for a
causal link between LD and retrobulbar optic neuritis or
neuroretinitis. There is sufficient evidence to establish a causal link
between LD and papillitis and posterior uveitis.

PMID: 15937426 [PubMed - in process]

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