Type of test Blood

Normal findings

Borrelia burgdorferi antibody Enzyme Immunoassay (Lyme index value)

 < 0.9 = negative 0.91-1.09 = equivocal > 1.1 = positive

Western blot

 ≥ 5 different IgG antibodies reactive = positive

 ≥ 2 different IgM antibodies reactive = positive

 PCR: negative

 CSF: negative

Test explanation and related physiology

 Lyme disease is a bacterial infection caused by a spirochete called B. burgdorferi. This is the most common tickborne disease. The spirochete is spread by a bite from a black-legged tick (Ixodes pacificus) or deer tick (Ixodes scapularis). These ticks normally dwell on animals, such as deer, horses, chipmunks, and squirrels, that are found in wooded areas.

Screening serologic studies are performed for the detection of Lyme disease. ELISA is the best diagnostic test for Lyme disease antibodies. This test determines titers of specific IgM and specific IgG antibodies to the B. burgdorferi spirochete. Levels of specific IgM antibody peak during the third to sixth week after disease onset and then gradually decline. Titers of specific IgG antibodies are generally low during the first several weeks of illness, reach maximal levels in 4 to 6 months, and often remain elevated for years. According to the International Lyme and Associated Diseases Educational Foundation, no testing is needed when a patient has tick exposure, tick bite, rash, and other symptoms.

Lyme disease can be confused with various viral infections. In these patients, a single titer of specific IgM antibody may suggest the correct diagnosis. Acute and convalescent sera can be tested to verify the diagnosis with a significant rise in positive antibody titers. Positive or equivocal ELISA screening test results should not be interpreted as truly positive until verified with a confirmatory Western blot assay. The Western blot antibody assay can identify specifically the IgG or the IgM antibody. The Western blot assay is considered positive for IgG if 5 or more of the 10 significant electrophoretic bands are considered positive for B. burgdorferi–specific IgG antibody. The Western blot IgM antibody assay is considered positive if two or more of three significant electrophoretic bands are considered positive for B. burgdorferi IgM antibody. However, the screening test or Western blot for B. burgdorferi antibodies may be falsely negative in early stages of Lyme disease, including the period when erythema migrans rash is apparent. Also, it is important to note that the compromised immune state of patients with chronic Lyme disease interferes with production of these antibodies.

In the near future, genomic testing may be able to not only identify more conclusively the presence of Lyme disease but also identify co-infections and secondary infections. When available, it is hoped that this new testing will also be helpful in selecting drug therapy and tracking improvement.

Interfering factors

 • Previous infection with B. burgdorferi can cause positive serologic testing results. These patients may no longer have Lyme disease.

• Other spirochete diseases (syphilis or leptospirosis) can cause false-positive results.

 Procedure and patient care

 • See inside front cover for Routine Blood Testing.

• Fasting: no

• Blood tube commonly used: red

Abnormal findings

Lyme disease

اخر الاخبار

اخبار العتبة العباسية المقدسة

العتبة العباسية المقدسة تواصل تنظيم مجالس العزاء الصباحية بذكرى زيارة عاشوراء

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شعبة الحرم الشريف تواصل تنفيذ خطتها الخاصة بشهر المحرّم داخل مرقد أبي الفضل العباس (عليه السلام)

المزيد

الآخبار الصحية

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المزيد

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المزيد

مواضيع ذات صلة

Magnesium

luteinizing hormone (LH assay, Lutropin) and follicle stimulating hormone (FSH) assay

liquid biopsy (Fluid biopsy, Fluid phase biopsy)

lipoproteins (High-density lipoproteins [HDLs, HDL-C], Low density lipoproteins [LDLs, LDL-C], Very-low-density lipoproteins [VLDLs], Lipoprotein electrophoresis, Lipoprotein phenotyping, Lipid fractionation, Non-HDL cholesterol, Lipid profile)

lipoprotein-associated phospholipase A2 (Lp-PLA2 PLAC test)

Hemolytic Anemias

Sickle Cell Anemia (Hemoglobinopathy S, Sickle Cell Disease)

Laboratory Diagnosis (Phenotypic) of Thalassemias

Pathophysiological and General Clinical Aspects of β-thalassemias

lipase (Pancreatic lipase, Lipoprotein lipase)

leucine aminopeptidase (LAP)

Legionnaires disease antibody test