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April 1991

Lyme Test Problems-Reply

Author Affiliations

Old Lyme, Conn

Arch Intern Med. 1991;151(4):816. doi:10.1001/archinte.1991.00400040143039

In Reply. —  Dr Cameron brings up two points that were not discussed in our article.1 His supposition that the university laboratory (laboratory E) that detected antibodies to Borrelia burgdorferi in 100% of the specimens was also our reference laboratory is incorrect. In fact, laboratory E was not the laboratory used in the initial serodiagnosis of any of the patients (because they do not routinely test for separate IgG and IgM antibodies). Rather, laboratories F and G had confirmed the seropositivity of these patients at dates prior to obtaining the study specimens. In addition, the conclusion of the study was not that laboratory E obtained the correct response, but, rather, that there was marked variability in the sensitivity of laboratories in detecting antibodies to B burgdorferi on the same specimens.Cameron's statement that the article was "misleading in not commenting on serologic testing" in patients who are seronegative but