Significance of reactive lyme serology in multiple sclerosis

Coyle, Patricia K.; Krupp, Lauren; Doscher, Carol

doi:10.1002/ana.410340521

Cited by 47 publications

(17 citation statements)

References 14 publications

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“…However, these infections are usually severe enough to be revealed by clinical history, leading to the exclusion of one sibling pair from the present study. A positive Borrelia serology in an MS patient with no suggestive features of the infection is unlikely to indicate neurological Lyme disease [7]. Notably, the healthy volunteer with low serum Borrelia titers in the present series was not one of the individuals with at least two CSF-enriched OCBs.…”

Section: Discussionmentioning

confidence: 94%

Incidence of CSF abnormalities in siblings of multiple sclerosis patients and unrelated controls

et al. 2000

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We found that 19% (9/47) of healthy siblings of patients with clinically definite multiple sclerosis had an intrathecal immunological reaction with two or more 2 CSF-enriched oligoclonal bands (OCBs), in contrast to (4%) (2/50) unrelated healthy controls. Furthermore, in this group of nine healthy sibs the measles CSF IgG antibody titers were higher than that of the other sibs and that of controls. There were also differences in the serum titers for measles IgG antibody, which were higher in the group of all healthy sibs than in healthy volunteers, and (as with CSF titers) higher in the subgroup of healthy sibs with two or more 2 CSF-enriched OCBs than the other sibs. Thus a significant proportion of healthy siblings to MS patients have a partially hyperimmune condition similar to that occurring in MS, which in 19% manifested itself as an OCB reaction, in 9% as increased CSF measles IgG antibody titers, and in 21% as increased serum measles IgG antibody titers, these phenomena tending to occur in the same individuals. This condition is characterized by CSF-enriched OCBs with undefined specificity, although some increased antiviral reactivity is found both in the serum and CSF. While it needs further characterization, a genetic trait interacting with common infections is suggested. The recurrence risk of this condition is approximately five times higher than the 3-4% recurrence risk for manifest MS reported for sibs.

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Section: Discussionmentioning

confidence: 94%

Incidence of CSF abnormalities in siblings of multiple sclerosis patients and unrelated controls

et al. 2000

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“…Encephalomyelitis may be a manifestation of Lyme neuroborreliosis, mimicking a first episode of relapsing-remitting multiple sclerosis (RR MS) (Halperin et al, 1996). Therefore, several studies have addressed the possibility of an association between Lyme borreliosis and MS. Only a minority of MS patients were found to be positive for serum Borrelia burgdorferi antibodies, and none of these patients had evidence of intrathecal synthesis of specific antibodies (Coyle et al, 1993), the latter being a hallmark of neuroborreliosis (Hammers-Berggren et al, 1993). We report on a case with clinical RR MS and serologic evidence of transient intrathecal antibody production against B. burgdorferi.…”

Section: Discussionmentioning

confidence: 89%

Headache and musculoskeletal symptoms

Fishbain

2003

Euro J of Neurology

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“…Detection of nonspecific autoantibodies is common in patients with MS. Low-titer antinuclear antibodies (ANA) occur in 2.5-81 % of patients with MS. [47,48] Antiphospholipid antibodies (aPLs) [49,50], as well as other antibodies such as anti-Ro (SS-A), are also detected [51,52]. False-positive fluorescent treponemal antibodies occur in a small number of MS patients [53] as do antibodies to Borrelia burgdorferi, the agent of Lyme disease, without evidence of active infection [54,55]. The pathophysiologic and clinical significance of these antibodies is not established and rarely influences the diagnosis when detected.…”

Section: Laboratory Tests In Patients With Suspected Msmentioning

confidence: 98%

A Clinical Approach to the Differential Diagnosis of Multiple Sclerosis

Toledano

Weinshenker

Solomon

2015

Curr Neurol Neurosci Rep

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The diagnostic criteria for multiple sclerosis (MS) rely on clinical, paraclinical, and radiographic findings of limited specificity. Many disorders mimic MS, and the decision of when to investigate an alternative diagnosis can be challenging. Reliance on extensive ancillary testing to exclude potential mimics, however, is unnecessary in most cases. Rather, recognition and rigorous interpretation of "classic" clinical and radiographic features of MS are often sufficient to establish the diagnosis. Misinterpretation of the clinical and radiographic diagnostic criteria for MS in the setting of more common diseases and syndromes and a lack of vigilance for "red flags" are important contributors to misdiagnosis. A clinical framework for the differential diagnosis of MS that emphasizes phenotypes atypical for MS and suggests diseases or syndromes in which they more commonly occur may be an important diagnostic guide for clinicians in contemporary practice.

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Significance of reactive lyme serology in multiple sclerosis

Cited by 47 publications

References 14 publications

Incidence of CSF abnormalities in siblings of multiple sclerosis patients and unrelated controls

Incidence of CSF abnormalities in siblings of multiple sclerosis patients and unrelated controls

Headache and musculoskeletal symptoms

A Clinical Approach to the Differential Diagnosis of Multiple Sclerosis

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