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@ARTICLE{Schneider:873607,
      author       = {Schneider, Christian and Gielen, Jörg and Röth, Philip
                      and Albrecht, Philipp and Schroeter, Michael and Fink,
                      Gereon R. and Wunderlich, Gilbert and Lehmann, Helmar C.},
      title        = {{Q}uantitative serological antibody testing for suspected
                      neuroborreliosis},
      journal      = {Journal of neurology},
      volume       = {267},
      number       = {5},
      issn         = {0340-5354},
      address      = {Berlin},
      publisher    = {Springer85301},
      reportid     = {FZJ-2020-00850},
      pages        = {1476-1481},
      year         = {2020},
      abstract     = {ObjectiveTo assess the importance of serum IgG/IgM antibody
                      titers for the differentiation of Lyme neuroborreliosis
                      (LNB) from its mimics.MethodThis was a retrospective,
                      cross-sectional study conducted at two German neurological
                      centers. Serological parameters (ELISA or CLIA analysis) and
                      clinical presentation of 28 patients with definite LNB were
                      compared to those of 36 patients with neurological symptoms
                      mimicking LNB (mimics). Analysis was performed using
                      receiver operating characteristic (ROC) and binary logistic
                      regression.ResultsElevated IgG-titers had a high sensitivity
                      for neuroborreliosis in both centers (0.95 and 1.0). The
                      optimal cutoff-values were set to 26.35 in center A (ELISA),
                      and 64.0 in center B (CLIA). Diagnostic specificity was 0.41
                      and 0.89 in this constellation. Elevated IgM-titers showed a
                      high diagnostic specificity for a cutoff at 68.10 (A) and
                      47.95 (B) (0.93 and 0.89). Sensitivity was 0.45 and 0.5.
                      Overall diagnostic accuracy was low in both centers (A: IgG
                      AUC = 0.665, IgM AUC = 0.629; B: IgG
                      AUC = 0.917, IgM AUC = 0.556). In logistic
                      regression of antibody titers and clinical measures,
                      prediction of LNB was significantly better than the “null
                      hypothesis”. Clinical measures showed the highest odds
                      ratio.ConclusionData show that in addition to the clinical
                      presentation of patients with symptoms suggesting central or
                      peripheral nervous system manifestation, serum IgG- and
                      IgM-titers help to identify LNB-patients. The results should
                      guide physicians counseling patients with suspected LNB
                      about further diagnostic steps and treatment.},
      cin          = {INM-3},
      ddc          = {610},
      cid          = {I:(DE-Juel1)INM-3-20090406},
      pnm          = {572 - (Dys-)function and Plasticity (POF3-572)},
      pid          = {G:(DE-HGF)POF3-572},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:32008071},
      UT           = {WOS:000510362000003},
      doi          = {10.1007/s00415-020-09721-7},
      url          = {https://juser.fz-juelich.de/record/873607},
}