LTT-Validity in diagnosis and therapeutical decision making of neuroborreliosis: a prospective dual-centre study

The key objective of this study was to assess the validity of a commercially available in-house Lymphocyte Transformation Test (LTT) as a diagnostic parameter and indicator of disease activity/therapeutic efficacy in the context of Lyme neuroborreliosis (LNB).

A prospective dual-centre study was conducted from 05/14 − 01/18. With respect to Borrelia-LTT a comparison was made between patients suffering from confirmed acute LNB and patients being affected by inflammatory neurologic diseases, defining the control group: Bell‘s palsy, viral meningitis, herpes zoster, Guillain-Barré-Syndrome and Encephalomyelitis disseminate. Furthermore, we investigated the LTT within the LNB group at the time of admission and again 12 weeks (+/- one week) later - after appropriate antibiotic treatment.

Cases included 15 patients with LNB and 58 participants in the control group. With regard to Borrelia-LTT we calculated a low sensitivity of 40% and a moderate specificity of 91% for LNB. Additionally, LTT-levels three months after adequate antibiotic therapy did not correlate with the therapeutic response of LNB patients.

The present study shows that LTT is neither appropriate for LNB detection nor suitable as a follow-up marker.