Potential impact of IVIG treatment on Lyme serology

Zóka, András; Bekő, Gabriella

doi:10.1016/j.diagmicrobio.2020.114986

Cited by 4 publications

(3 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, the prevalence of anti-Bbsl antibodies depends on geographical region [8], possibly explaining the difference in apparent seroconversion between patients receiving Nanogam, a Dutch product, and Privigen, produced in either the USA or Germany. The finding that the C6 Lyme index was positive in Nanogam and negative in Privigen, is in accordance with previous findings [3].…”

Section: Discussionsupporting

confidence: 93%

“…Intravenous immunoglobulins (IVIg) are used in the treatment of inflammatory neuromuscular disorders, such as chronic inflammatory demyelinating polyneuropathy (CIDP) and myositis [1,2]. IVIg consist of pooled polyclonal immunoglobulin G (IgG) immunoglobulins from at least a thousand donors per batch, including antibodies directed towards different microorganisms that the donors have encountered such as Borrelia burgdorferi sensu lato (Bbsl) [3]. Because Lyme borreliosis is an important differential diagnosis in patients with CIDP, serological testing for Bbsl is frequently performed [4].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Borrelia burgdorferi sensu lato seroconversion after intravenous immunoglobulin treatment: A cohort study

Lucke

Vrijlandt

Lim

et al. 2021

Euro J of Neurology

View full text Add to dashboard Cite

Objective Intravenous immunoglobulin (IVIg) consists of pooled donor immunoglobulins (IgG), possibly including anti‐Borrelia burgdorferi (Bbsl) antibodies. Apparent IVIg‐related Bbsl seroconversion could lead to incorrect diagnosis of Lyme borreliosis. This cohort study was designed to determine how often IVIg treatment leads to apparent Bbsl seroconversion and whether antibodies disappear post‐treatment. Methods Sera from chronic inflammatory demyelinating polyneuropathy (CIDP) and myositis patients were analyzed, drawn pre‐treatment and 6–12 weeks after the start of IVIg. In patients with apparent seroconversion, follow‐up samples after treatment withdrawal were analyzed, if available. Patients treated with corticosteroids were included as controls. A two‐tier protocol was used for serological testing consisting of the C6 Lyme ELISA (Oxford Immunotec) and confirmation by immunoglobulin M (IgM) and immunoglobulin G (IgG) immunoblot (Mikrogen®). Results We included 61 patients: 51 patients were treated with IVIg and 10 with dexamethasone. Of the patients treated with IVIg, 42 had CIDP (82%) and were treated with Nanogam® (Sanquin Plasma Products). Nine patients had myositis (18%) and were treated with Privigen® (CSL Behring). Anti‐Bbsl IgG seroprevalence pre‐treatment was 3% (2/61). Apparent seroconversion during IVIg treatment occurred in 39% (20/51) of patients, all treated with Nanogam. Post‐treatment seroreversion occurred in 92% (12/13) of patients with available follow‐up samples; in 78% (7/9) seroreversion was observed within 3 months. Conclusions Transient presence of anti‐Bbsl IgG antibodies after IVIg is regularly observed. This effect appears to be dependent on the IVIg brand, probably reflecting variation in Bbsl exposure of plasma donors. Lyme borreliosis serological testing during, and weeks to months after, IVIg is therefore of limited utility.

show abstract

Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Borrelia burgdorferi sensu lato seroconversion after intravenous immunoglobulin treatment: A cohort study

Lucke

Vrijlandt

Lim

et al. 2021

Euro J of Neurology

View full text Add to dashboard Cite

show abstract

“…This includes false‐positive Galactomann antigen tests for aspergillosis, 8,28,29 false‐positive serological tests for syphillis, 5,29,30 and false‐positive rK39 rapid diagnostic tests for leishmaniasis 6 . There are also false‐positive results for a wide range of infectious agents (viral, bacterial, and protozoal) in human patients receiving immunoglobulin therapy IV 31‐35 . The mode of interference in the Leishmania assay in the described case could be associated with the paraprotein cross‐linking the antigen with the conjugate antibody, 28 or an inability to remove unbound antibody conjugate by the washing procedure.…”

Section: Discussionmentioning

confidence: 90%

Spurious laboratory results associated with immunoglobulin M gammopathy in a dog with multiple myeloma

Loane

Castillo

Peschard

et al. 2022

Veterinary Internal Medicne

View full text Add to dashboard Cite

An 11 year old female-neutered Labrador presented for facial swelling. Clinicopathological abnormalities included hyperglobulinemia, azotemia, hypercalcemia, nonregenerative anemia, thrombocytopenia, and spurious hypoglycemia. Normoglycemia was subsequently confirmed using a cage-side analyzer (AlphaTRAK, Zoetis, UK). Serum and urine protein electrophoresis documented monoclonal (immunoglobulin M) gammopathy with Bence-Jones proteinuria. Computed tomography imaging revealed a monostotic osteolytic bone-lesion, and bone marrow cytology and histopathology documented plasmacytosis with multiple myeloma oncogene 1 / interferon regulatory factor 4 positivity, consistent with multiple myeloma. Infectious disease testing initially indicated seropositivity for Leishmania, Borrelia, and Anaplasma spp.; however, Leishmania PCR (splenic and bone marrow aspirates), and paired serological titers for Borrelia and Anaplasma were negative. Consequently, initial serological results were considered to be false positive because of paraproteinemia-associated assay interference. Chemotherapy (prednisolone and melphalan combination therapy) was initiated, but the dog was euthanased 30 days later because of the development of pericardial effusion. This is a report of spurious serological (and other laboratory) results occurring secondary to monoclonal gammopathy in a dog.

show abstract

False-positive Trypanosoma cruzi serology in a cancer patient receiving intravenous immunoglobulin

Yibirin

Pritchard

Torres

2020

Diagnostic Microbiology and Infectious Disease

View full text Add to dashboard Cite

Potential impact of IVIG treatment on Lyme serology

Cited by 4 publications

References 4 publications

Borrelia burgdorferi sensu lato seroconversion after intravenous immunoglobulin treatment: A cohort study

Borrelia burgdorferi sensu lato seroconversion after intravenous immunoglobulin treatment: A cohort study

Spurious laboratory results associated with immunoglobulin M gammopathy in a dog with multiple myeloma

False-positive Trypanosoma cruzi serology in a cancer patient receiving intravenous immunoglobulin

Contact Info

Product

Resources

About