Journal
SCANDINAVIAN JOURNAL OF INFECTIOUS DISEASES
Volume 45, Issue 7, Pages 526-530Publisher
INFORMA HEALTHCARE
DOI: 10.3109/00365548.2013.776700
Keywords
Lyme neuroborreliosis; cerebrospinal fluid; children; CXCL13
Categories
Funding
- National Technology Agency (TEKES)
- Biomedicum Helsinki Foundation
- Orion-Farmos Research Foundation
- Finnish Concordia Found
- Helsinki University Central Hospital, Finland
- County Council in Ostergotland
- Centre for Clinical Research in Dalarna (CKF)
- Lions Foundation
- Samaritan Foundation
- Holmia Foundation, Sweden
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Background: The diagnosis of Lyme neuroborreliosis (LNB) requires laboratory confirmation because neurological symptoms indicative of LNB are not specific. Recent studies have suggested that a chemokine, CXCL13, could have an important role in the diagnosis of LNB. The aim of this study was to assess CXCL13 levels in the cerebrospinal fluid (CSF) of children with LNB. Methods: CSF samples were available for 57 children with symptoms indicative of LNB. Based on the presence of anti-flagella antibodies and pleocytosis in CSF, patients were divided into 3 different groups: confirmed LNB (n = 24), possible LNB (n = 16), and non-LNB (n = 17). CXCL13 levels were determined with a commercial kit (Quantikine). Results: All 24 patients with confirmed LNB had elevated CXCL13 levels in CSF. Elevated CXCL13 was also observed in the majority of patients without anti-flagella antibodies in the CSF (possible LNB). Of the 17 non-LNB and 50 control samples, 1 was positive. Conclusions: In LNB, the production of CXCL13 in CSF seems to precede antibody production. Assessment of CSF CXCL13 may improve the diagnostics for children with possible LNB.
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