Table 7 CSF findings in patients with neuroborreliosis
From: S1 guidelines “lumbar puncture and cerebrospinal fluid analysis” (abridged and translated version)
Parameter | Diagnostic LP | LP after initiating antibiotic treatment | Remarks |
|---|---|---|---|
Cell count | ≤4/μL: 0% 5-30/μL: 1% > 30/μL: 99% | normalized | Increase may indicate reinfection |
Cell type | - lymphocytes: - activated lymphocytes or Plasma cells: up to 20% | normalized | |
Albumin ratio | < 8 × 10−3: 1% 8-32 × 10− 3: 99% | normalized | |
Quantitative IgG, IgA, and IgM synthesis | IgM > 0%: 70% IgG > 0%: 20% IgA > 0%: 1% | May persist for years | |
OCBs | positive in 70% of neuroborreliosis patients | May persist for years | Differentiatial diagnosis for multiple sclerosis is necessary |
Borrelia AI ≥1.5 | positive in > 80% | May persist for years | Not suitable in suspected reinfection |
Borrelia PCR in CSF | Positive in 10-30% | Negative after appropriate antibiotic treatment | |
Lactate | < 3.5 mmol/L: 95% > 3.5 mmol/L: 5% | ||
CXCL13 | Sensitivity 80 - 100% | Normalized after antibiotic treatment | Not specific, elevated in CNS lymphoma and inflammation |