Quality of Lyme Disease Tests

In this issue ofThe Journal, Schwartz and colleagues¹report interlaboratory differences in serological test results for Lyme disease. Their findings confirm earlier results²and show that the rising number of tests performed in areas endemic for this disease can be very high. Lyme disease continues to receive major attention by the news media. Consequently, with the knowledge that the characteristic skin lesion erythema migrans may not always develop and that there is potential for long-term disorders that may be confused with other maladies, the public and the medical community have relied heavily on serum antibody tests for diagnosis. When patients are in the later stages of Lyme disease, marked by neurological or arthritic disorders, clinicians sometimes are faced with great difficulty in making a diagnosis. Like many other laboratory tests, assays for Lyme disease are less than perfect, and, as expressed by Schwartz et al,¹some