The Clinical Observation Of Positive And Weakly Positive Results For Serum Borrelia Burgdorferi IgM Antibodies In Uveitis Cases

Purpose: By observing and analyzing the positive and weakly positive results forserum Borrelia burgdorferi IgM antibodies in uveitis cases, we master the clinicalmanifestations and treatment of Lyme uveitis, discuss the changing of IgM and IgGantibodies titer, in order to guide diagnosis and treatment.Methods:16uveitis patients with suspected clinical manifestations of Lyme diseaseand17healthy controls were recruited. The detection on IgM and IgG antibodies ofBorrelia burgdorferi was carried out in serums with enzyme-linked immunosorbentassay (ELISA). Patients who tested positive and weakly positive results of IgMantibodies were given retrospective analysis and following observation.Results: Among all14uveitis patients,4patients had positive reactions of Borreliaburgdorferi IgM antibodies,10patients tested weakly positive results.7of14patientshad weakly positive results of IgG antibodies,9were negative and no positive case.1patient(7.14%) recalled a tick bite,3patients(21.43%) had worked in the wild andconnected with bushes,1patient(7.14%) had skin lesion,3patients(21.43%) hadnervous system manifestations, while all patients had arthralgias, the knee,lumbosacral and hip joints were most frequently involved.11patients(78.57%) hadcorneal injury of inflammation and temporary high intraocular pressure respectively.13patients(92.86%) suffered from repeated uveitis attacks. One patient with positiveresult of IgM antibody and negative result of IgG antibody developed negative IgMantibody after the onset of disease for14months, and weakly positive IgG antibodyafter the onset of disease for10months who treated by antibiotic. Another patient with positive IgM antibody and weakly positive IgG antibody developed weaklypositive IgM and IgG antibodies after antibiotic treatment.17healthy controls hadnegative results in both IgM and IgG antibodies.Conclusions: Hubei Province has sporadic cases of Lyme uveitis. Early and rapidlydiagnosis of Lyme disease will guide doctors to determine the treatment and isimportant to the prognosis of patients. Lyme disease is a multisystem infection whichhas complicated manifestations and is likely to confuse with other disease, thereforelaboratory results is of great importance to diagnosis and differential diagnosis. Thedetection of Borrelia burgdorferi should be widely used in clinical practice.Diagnostic therapy by antibiotics should be used for highly suspicious cases iflaboratory testing are not performed. Antibiotics should be prudently used for thetreatment of uveitis patients, who cannot be ruled out the infection of Borreliaburgdorferi.