Experiencia en las Islas Canarias orientales en la búsqueda de la enfermedad de Lyme

BACKGROUND: The eastern region of Canary Islands presents certain climatic and atmospheric conditions which differentiate it from the accepted parameters in cases of Lyme disease. We present a serologic study of patients with clinical syndrome which is potentially compatible with Lyme disease, in an effort to clarify the presence of this disorder region. MATERIAL AND METHODS: We assayed type IgG and IgM antibodies against the flagellin antigen of the native Borrelia burgdorferii using indirect enzymeimmunoassay (EIA) as a screening technique. In the serum presenting positive screening we confirmed this result with immunoblot (IB) type IgG and/or IgM with synthetic peptides for the antigenic epitopes p14, p41, p100, OspA and OspC. We review the clinical history of the patients with reactive sera. RESULTS: We studied a sample group of 1,452 patients considered clinically compatible with Lyme disease over a 42-months period, presenting the screening results for serologic positive 47 (3.2%). From this sample, 24 (1.65%) were IB reactive, independent of the type of immunoglobulin. Only two fulfilled the criteria of both IB-IgM positive, one with antibodies against OspC and p41 proteins finally diagnosed as arteriosclerotic encephalopathy suboccipital Binswanger and another with antibodies against p100 and p41 proteins, diagnosed as presenting a primary cytomegalovirus disease. The bands that, most often lead to reactive IB were p41 and p14. Of the 24 patients who presented reactive IB, 14 (58.3%) also presented other previous data wich produced the false positives, 8 with autoimmune disease, 5 viral infectious and one infection due to Treponema pallidum. CONCLUSION: Due to the lack of studies carried out in this field which would verify or rule out an epidemiologic chain in our region, our serologic and clinical data put the eastern Canary Islands in doubt as an endemic area of Lyme disease.