Diagnostic value of urine PCR in ocular lyme borreliosis
M. Scherer, U. Pleyer, S. Priem*, L. Bergmann, G. Burmester*, A. Krause*
Purpose: Uveitis is a well recognized manifestation of Lyme borreliosis, but the diagnosis might be delayed because of unspecific clinical findings and slow development of a detectable humoral immune response. This study was initiated to evaluate the diagnostic value of B. burgdorferi PCR in urine of patients with ocular Lyme borreliosis.
Methods: Six patients with uveitis and clinical evidence for Lyme borreliosis were enrolled in this sudy. Thirty patients with non-Lyme uveitis served as controls. Lyme serology was performed by full antigen ELISA and Western blotting. Urine samples were examined by an optimized nested PCR protocol for the detection of B. burgdorferi DNA using two different primer sets.
Results: Only two of six patients with ocular borreliosis were seropositive for specific antibodies against B. burgdorferi antigens in ELISA, while all six subjects showed a positive Western blot result. B. burgdorferi PCR in urine specimens was positive with at least one primer set in all uveitic patients. In contrast, only four of the 30 controls had a positive Lyme serology (two in ELISA, four in Western blot), and B. burgdorferi DNA was detectable by PCR in none of the urine samples from these patients.
Discussion: PCR for the detection of B. burgdorferi DNA in urine of patients with intraocular inflammation might be a valuable laboratory tool to support the diagnosis of ocular Lyme borreliosis. However, its sensitivity and specificity needs to be determined.
Supported by DFG (Pl 150/9-1, Kr 997/2-1)
Departments of Ophthalmology and Rheumatology*, Charité, Humboldt University, Augustenburger Platz 1, D-13353 Berlin