Is History Useful in the Diagnosis of Lyme Borreliosis?

Hilton, Eileen; Stoica, Dorin; Ravdin, Lisa; Acampora, Matthew D.; Lam, Stanley; Barr, William

doi:10.1097/00019048-199407000-00008

Cited by 3 publications

(2 citation statements)

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“…By use of the above algorithm, the posttest probability of Lyme disease as a function of the pretest probability is illustrated in figure 1. For selfreferred persons from areas in which Lyme disease is highly endemic with atypical symptoms (e.g., myalgias and fatigue), the prior probability of Lyme disease may be at most 1%-3% [7,13]. In this low-risk setting, the posttest probability of Lyme disease may be only 4%-10%, even though both the EIA and Western blot assay are positive ( figure 1).…”

Section: Resultsmentioning

confidence: 99%

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A Reanalysis of IgM Western Blot Criteria for the Diagnosis of Early Lyme Disease

Porwancher

1999

J INFECT DIS

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A two-step approach for diagnosis of Lyme disease, consisting of an initial EIA followed by a confirmatory Western immunoblot, has been advised by the Centers for Disease Control and Prevention (CDC). However, these criteria do not examine the influence of the prior probability of Lyme disease in a given patient on the predictive value of the tests. By using Bayesian analysis, a mathematical algorithm is proposed that computes the probability that a given patient's Western blot result represents Lyme disease. Assuming prior probabilities of early Lyme disease of 1%-10%, the current CDC minimum criteria for IgM immunoblot interpretation yield posttest probabilities of 4%-32%. The value of the two-step approach for diagnosis of early Lyme disease may be limited in populations at lower risk of disease or when patients present with atypical signs and symptoms.

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Section: Resultsmentioning

confidence: 99%

“…An anticipated range of pretest probabilities of Lyme disease was estimated from recently published reports from Lyme disease referral centers in areas endemic for Lyme disease [6][7][8][9]. The prevalence of active Lyme disease in this setting ranged from 1% in self-referred patients to 40% in physician-referred patients.…”

Section: Methodsmentioning

confidence: 99%

A Reanalysis of IgM Western Blot Criteria for the Diagnosis of Early Lyme Disease

Porwancher

1999

J INFECT DIS

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Relations Among Indexes of Memory Disturbance and Depression in Patients With Lyme Borreliosis

Barr¹,

Rastogi²,

Ravdin³

et al. 1999

Applied Neuropsychology

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This study examined the relation between complaints of memory disturbance and measures of mood and memory functioning in 55 patients with serological evidence of late-stage Lyme Borreliosis (LB). Patients completed the Self-Ratings of Memory Questionnaire (SRMQ) and the Beck Depression Inventory. Memory functioning was assessed with the California Verbal Learning Test. Depressed patients exhibited more frequent complaints of memory disturbance on the SRMQ, although their pattern of responses did not differ from nondepressed patients. There was a significant correlation between subjective memory ratings and self-reported depression (Spearman rho = -.57, p < .001). No relation was observed between subjective memory ratings and objective memory performance. The results indicate subjective complaints of more severe memory disturbance in patients with LB and depression. Particular attention should be paid to the assessment of depression and subjective symptoms of memory disturbance when administering neuropsychological tests of memory functioning in patients with LB.

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The Neuropsychological Examination of Naming in Lyme Borreliosis

Svetina

Bart²,

Rastogi³

et al. 1999

Applied Neuropsychology

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Although subjective complaints of word finding and naming deficits are commonly reported by patients with Lyme Borreliosis (LB), the existence of these disturbances has not been thoroughly investigated. Forty-four patients with LB and 43 healthy controls were administered a symptom questionnaire, the Boston Naming Test (BNT), the Controlled Oral Word Association Test (COWAT), and a series of category naming tasks. LB patients had a higher rate of complaints of word-finding disturbance (55% vs. 14%). Lower mean scores were observed on the BNT, but not on the COWAT, nor on category naming tasks. Thirty-six percent of the LB sample exhibited BNT scores in the impaired range. BNT scores in this group were correlated with a measure of memory retrieval, but not with verbal fluency indexes. There was no relation between naming scores and depression. LB patients exhibit impairments in word finding that appear to be secondary to a generalized retrieval deficit.

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Is History Useful in the Diagnosis of Lyme Borreliosis?

Cited by 3 publications

References 0 publications

A Reanalysis of IgM Western Blot Criteria for the Diagnosis of Early Lyme Disease

A Reanalysis of IgM Western Blot Criteria for the Diagnosis of Early Lyme Disease

Relations Among Indexes of Memory Disturbance and Depression in Patients With Lyme Borreliosis

The Neuropsychological Examination of Naming in Lyme Borreliosis

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