Are high CSF levels of CXCL13 helpful for diagnosis of Lyme neuroborreliosis?

摘要

Neuroborreliosis (NB) is a serious complication of infection with the spirochete Borrelia burgdorferi that presents with a variety of clinical manifestations. Identification of Lyme NB and the decision to treat with IV or oral antibiotics are common challenges. For persons in endemic areas who present with classic manifestations of Lyme NB and evidence of systemic infection with B burgdorferi, the diagnosis is straightforward. However, for cases with atypical manifestations or ambiguous serology, diagnostic confirmation of Lyme NB can be difficult. The current method of choice for diagnosis of Lyme NB is the demonstration of CSF abnormalities (i.e., increased leukocyte count or elevated albumin CSF/serum ratio, indicating blood-CSF barrier dysfunction) plus the demonstration of intrathecal synthesis of Borrelia-specific antibodies.