REPORTS
ALLEN STEERE, 27 YEARS AGO: "In both syphilis and Lyme disease,
serodiagnostic tests often give false-negative results early in the
illness (12, 36, 37). However, in syphilis, use of a
flagellar-associated protein to which an early IgM response is directed
(37), rather than a crude sonicate of spirochetes on the solid phase of
an ELISA, improved the-sensitivity of the test (36). This observation
suggests that the 41 -kD antigen of B. burgdorferi may give better
results in an ELISA for early Lyme
disease than the current test, which uses sonicated whole spirochetes (1
1, 12). Furthermore, in this study, IgM antibodies to the 41-kD
polypeptide were usually apparent by immunoblots before IgM titers were
elevated by the current ELISA (12). Although antibodies reactive against
this antigen may be present in patients with relapsing fever or
syphilis (11,14), these diseases can be distinguished clinically from
Lyme disease and therefore should not cause diagnostic confusion. The
binding of this antigen by IgM from rheumatic disease controls was
typically very weak and could potentially be blocked to avoid
false-positive results in this group of patients." Per, Kathleen Dickson
Respectively.