n REVIEWS n Abbreviations AIR = automated immunoblot reader; AV-block = atrioventricular block; COMPASS = comparative immunoblotassay;EM=erythemamigrans;ENG=electro-neurographia;Lb=Lymeborreliosis;TIBOLA =tick-bornelymphadenopathy;WB=Westernblot Lyme borreliosis is usually benign, self limited illness in Europe but sometimes it unforeseenly shows a progressive course. W.Burgdorfer isolated the borrelia named after him and the disease becamewellknownonlyafterthisdiscoverywhichestablishedthepossibilityofserologicaldiag- DOI:10.1556/CEMED.3.2009.28576 Lyme Borreliosis – Lessons Learnt from 25 years ANDRÁS LAKOS Center for Tick-borne Diseases, Budapest, Hungary WerecognizedthefirstHungarianLymepatientsjust25yearsago,in1984.Itwasexactly 20 years ago, when we opened the Lyme Disease Outpatient Service at the Central (“László”) Hospital for Infectious Diseases. Fifteen years ago, we established the financially independentCenterforTick-borneDiseases.ThemilestonesofthisworkattheCenterfor Tick-borne Diseases are the description of a new tick-borne rickettsial illness (tick-borne lymphadenopathy),developmentofaLymeimmunoblotkitandanautomatedimmunoblot reader(AIR).Wedescribedasimpleandreliablemethodfordetectionofintrathecalborre- liaantibodysynthesiswhichisnecessaryforthediagnosisofneuroborreliosis.Wealsodevel- opedandroutinelyapplythecomparativeimmunoblotassayfortheevaluationofserological progression and/or regression, which can help the clinicians in the judgment whether a serological reaction is resulted from a previous, healed or an active borrelia infection. We studied the pregnancy outcome of borrelia infected mothers and provided the supporting data of that untreated borrelia infection results in higher chance of adverse pregnancy out- come. Keywords: Lymeborreliosis,erythemamigrans,Borreliaburgdorferi,TIBOLA(tick-borne lymphadenopathy),COMPASS(comparativeimmunoblotassay) Correspondingaddress: András Lakos MD, Visegrádi u. 14, H-1132 Budapest, Hungary. E-mail: alakos@t-online.hu 2009 n Volume3, Number 2 n 213–225. n 213 n