Seronegative Lyme Disease

To the Editor: Dattwyler and his associates (Dec. 1 issue)¹ make important and provocative observations about a group of patients with a clinical diagnosis of chronic Lyme disease who have no apparent serologic response to the causative agent, Borrelia burgdorferi. The specific T-cell proliferative response in these patients was similar to that found in a group of seropositive patients with chronic Lyme disease, suggesting that in some persons with this clinical syndrome, the T-cell and B-cell responses to B. burgdorferi are vastly unequal. One point needs clarification: although the serologic status of the patients seems to have been known…