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Allen C. Steere, MD
Tufts University School of Medicine Boston, Mass

JAMA. 1993;270(22):2683.

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In Reply.

—We did not ignore the clinical picture in diagnosing Lyme disease. On the contrary, the patients in our report were required to meet clinical criteria for one or more of the characteristic clinical manifestations of this disorder. We have never claimed that our serologic test for Lyme disease was "better" than those of other laboratories. However, based on the results of testing in our laboratory, 176 of the 180 patients (98%) who met clinical criteria for Lyme disease had serologic evidence of infection with B burgdorferi. Of the 452 patients who did not meet these criteria, none had a positive test result. Thus, in our study, there was a strong correlation between clinical diagnosis and serologic test results.

Of the 180 patients with Lyme disease, only four (2%) met clinical criteria for late manifestations of the disorder but had no antibody response to B burgdorferi. Three of these . . . [Full Text PDF of this Article]

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