To study the serological response to Borrelia burgdorferi
after treatment of late
Lyme borreliosis, consecutive serum samples from 20 patients with Borrelia
arthritis and 21 with
acrodermatitis chronica atrophicans were analysed with capture
IgM ELISA and indirect
IgG ELISA, both using B. burgdorferi flagella as
antigen. Seven patients had positive
IgM OD values, whereas all 41 had positive
IgG OD values before
therapy. In the majority, highly elevated
IgG OD values were seen. All patients improved after
antibiotic therapy, 32 recovering completely, while 9 had sequelae. At follow-up after 6 months to 5 years, 4/7 patients became negative
IgM ELISA, whereas 3 still had slightly elevated
IgM OD values 6 months, 1 year and 4.5 years, respectively, after
therapy. Only one patient became negative in
IgG ELISA during follow-up, although a significant decline in
IgG OD values was seen in 22 of the remaining 40 initially
IgG-positive patients. The serological response after successful treatment of Borrelia
arthritis and
acrodermatitis chronica atrophicans may persist for several years even with highly elevated
IgG OD values in patients who have recovered completely.