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Lyme Ab W Reflex Western Blot

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Lyme Disease Antibody W/ Reflex To Blot

Test Code: 6646

CPT Code: 86618

Includes: If Lyme Disease Antibody Screen is Equivocal or Positive, Lyme Disease Antibodies , Immunoblot will be performed at an additional charge : 86617 x2).

Methodology: Immunoassay

Clinical Significance: Lyme disease is caused by a bacterium borrelia burgdorferi and is transmitted by ticks. EIA is the screening test with high sensitivity for antibody detection. Immunoblot testing qualitatively examines with high specificity antibodies in a patients specimen. Immunoblot testing is appropriate for confirming a detected EIA test result.

Alternative Name: Borrelia burgdorferi, Lyme Screening, Lyme Antibody Screen

Collection Guide:

Lyme Disease Antibody With Reflex To Blot

NEW YORK DOH APPROVED: YES

CPT Code: 86618Order Code: C1473Includes: Lyme Disease Ab ScreenIf Lyme Disease Ab Screen is 0.90, then Lyme Disease Ab , Blot and Lyme Disease Ab , Blot will be performed at an additional charge .ABN Requirement: NoContainer: Gel-barrier tube

Collection:

  • Collect and label sample according to standard protocols.
  • Gently invert tube 5 times immediately after draw. DO NOT SHAKE.
  • Let tube stand in a vertical position to allow blood to clot 30 minutes.
  • Centrifuge for 10 minutes.
  • Transport: Store serum at 2-8°C after collection and ship the same day per packaging instructions included with the provided shipping box.

    Stability:

    Ambient : 7 daysRefrigerated : 14 daysFrozen : 30 days

    Causes for Rejection: Specimens other than serum improper labeling samples not stored properly samples older than stability limits grossly hemolyzed, grossly lipemic, or grossly icteric samples

    Methodology: Immunoassay Reflex: Immunoblot

    Turn Around Time: 3 to 4 days

    Reference Range:

    > 1.09

    Clinical Significance: Lyme Disease Antibody with Reflex to Blot Lyme disease is caused by a bacterium borrelia burgdorferi and is transmitted by ticks. A screening test with high sensitivity is used as the first step in the CDC recommended algorithm. Immunoblot testing qualitatively examines, with high specificity, antibodies in a patients specimen. Immunoblot testing is appropriate for confirming a detected screening result.

    AWARDS AND RECOGNITION

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    Key Points To Remember

    • Most Lyme disease tests are designed to detect antibodies made by the body in response to infection.
    • Antibodies can take several weeks to develop, so patients may test negative if infected only recently.
    • Antibodies normally persist in the blood for months or even years after the infection is gone therefore, the test cannot be used to determine cure.
    • Infection with other diseases, including some tickborne diseases, or some viral, bacterial, or autoimmune diseases, can result in false positive test results.
    • Some tests give results for two types of antibody, IgM and IgG. Positive IgM results should be disregarded if the patient has been ill for more than 30 days.

    Recommended Reading: Lyme Disease Diagnosis And Treatment

    Lyme Disease Blood Test Igm Early Test With Reflex

    CST

    A Lyme Disease Blood Test, IgM, Early Test With Reflex is used to detect Lyme disease antibodies, IgM, EIA supplementary Western blots for all positives from antibody test. Used to aid in the diagnosis of acute infection with the Lyme disease agent.

    Methodology: Enzyme immunoassay Western blot

    Preparation: No special preparation required.

    Test Results: 3-5 Days. May take longer based on weather, holiday or lab delays.

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    Question 7 What Are Some Prominent Limitations Of Serologic Testing For Lyme Disease

    As noted above, serologic tests may yield negative results early during infection, before antibodies have reached detectable levels. In addition, serologic assays may give false-positive results in individuals with other conditions, including 3,5,6

    • Pathogenic spirochetal diseases, such as syphilis, yaws, pinta leptospirosis, relapsing fever, and periodontal disease
    • Other bacterial and viral infections, such as Rocky Mountain spotted fever, Epstein-Barr virus, and cytomegalovirus
    • Connective tissue autoimmune diseases associated with positivity for anti-nuclear antibody, including rheumatoid arthritis and systemic lupus erythematosus

    What Abnormal Results Mean

    A positive ELISA result is abnormal. This means antibodies were seen in your blood sample. But, this does not confirm a diagnosis of Lyme disease. A positive ELISA result must be followed up with a Western blot test. Only a positive Western blot test can confirm the diagnosis of Lyme disease.

    For many people, the ELISA test remains positive, even after they have been treated for Lyme disease and no longer have symptoms.

    A positive ELISA test may also occur with certain diseases not related to Lyme disease, such as rheumatoid arthritis.

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    Question 4 What Tests To Assist In The Diagnosis Of Lyme Disease Are Available At Quest

    Serologic testing is the principal means of laboratory diagnosis of Lyme disease. Quest offers testing in accordance with the Centers for Disease Control and Prevention guidelines for early/acute Lyme testing.3 When laboratory diagnosis is indicated, current recommendations include using a 2-tier testing approach that begins with a sensitive enzyme immunoassay , followed by a confirmatory immunoassay for specimens yielding positive or equivocal results.3 In the standard 2-tier test algorithm, a Western blot or immunoblot assay is used for confirmation. However, on July 29, 2019, the US Food and Drug Administration cleared several Lyme disease serologic assays with new indications for use, which allowed an EIA to be used as the confirmatory test in a modified 2-tier testing algorithm.3 The MTTT algorithm is now considered an acceptable approach for the serologic diagnosis of Lyme disease and may be able to assist in the identification of early Lyme disease within the first 30 days of infection.3

    Quest offers test options that use both the STTT and the MTTT algorithm:

    • STTT: Lyme Disease Ab with Reflex to Blot
    • MTTT: Lyme Disease Antibody with Reflex to Immunoassay

    Click here for a complete list of additional tests for tick-borne infectious diseases available from Quest.

    Lyme Disease Ab With Reflex To Immyunoblot

    My 1st dose taken of Ivermectin, an anti-parasitic med to kill off worm, host of Lyme bacteria

    In the aiding of the diagnosis of acute or chronic infections with Lyme Disease, the Lyme Disease Antibodies, Total Immunoglobin IgG/Igm test is useful.

    The test can both detect IgM and IgG antibodies but doesn’t distinguish between the two.IgM antibodies develop in a short time after infection and vanish after a few months. IgG antibodies start to develop many weeks after infection and continue to exist.

    Also Check: Lyme Disease Ab Quant Igm

    Which Lyme Tests Should You Ask Your Doctor To Order

    Youve discovered you have some symptoms of Lyme disease. In fact, youve already made a doctors appointment with your primary care provider . Unfortunatelyor, rather, fortunatelyyou also know most only order one unreliable test. So, which other Lyme tests should you ask your PCP to order?

    Below youll find the blood tests my Lyme specialist ordered from insurance-covered LabCorp.

    Lyme Disease Immunoblot Test

    The Lyme Disease Immunoblot test is typically used as a confirmatory test for people who have had positive results from previous Lyme Disease testing. The immunoblot test is also known as a Lyme Disease Line Blot test. This test looks for the presence of both IgG and IgM antigen bands to confirm both recent and previous exposure. The detection of multiple bands is required for a positive result. The CDC does not recommend the Western Blot test as a front-line screening as some conditions other than Lyme Disease may cause a false positive.

    Lyme Disease is caused by infection with the bacteria Borrelia burgdorferi. It is most commonly spread by the Deer Tick or Black Legged Tick and is the most common tick-borne illness in the United States and Europe. Lyme disease can be difficult to diagnose because the symptoms are often similar to other afflictions. While some people will display a distinctive “bulls-eye” rash around the site of the bite, others may experience common flu-like symptoms such as fever, chills, fatigue, and headache. The ticks which spread the disease are typically very small and many people do not even realize they have been bitten. If left untreated, Lyme Disease can cause joint pain, numbness in the arms and legs, facial paralysis, Meningitis, heart problems, or memory problems.

    Turnaround time for the Lyme Disease Immunoblot test is typically 2-5 business days.

    Detection Period:

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    Question 2 How Is The Diagnosis Of Lyme Disease Made

    Diagnosis of Lyme disease is made through clinical assessment or clinical assessment supported by laboratory testing. The presence of an erythema migrans rash is diagnostic of Lyme disease without laboratory investigation.1,2

    Patients who do not develop a rash but have symptoms suggesting Lyme disease, and have been to areas with a high risk of tick exposure, may undergo laboratory testing to help identify the cause of symptoms.1,2 For more information, see the Quest Diagnostics Clinical Focus Tick-borne Diseases: Laboratory Support of Diagnosis and Management available here.

    Read Also: Lyme Disease How Is It Diagnosed

    Lyme Disease Total Antibodies Blood Test

    CST

    In the aiding of the diagnosis of acute or chronic infections with Lyme Disease, the Lyme Disease Antibodies, Total Immunoglobin IgG/Igm test is useful.

    The test can both detect IgM and IgG antibodies but doesn’t distinguish between the two.IgM antibodies develop in a short time after infection and vanish after a few months. IgG antibodies start to develop many weeks after infection and continue to exist.

    Contact with the bacteria Borrelia burgdorferi cause the infection that lead to Lyme Disease.

    Untreated Lyme Disease causes joint pain, arms and hands numbness, facial paralysis, Meningitis, heart problems or memory problems.

    Testing for Lyme Disease is advised when a person experiences symptoms associated with the Lyme Disease, especially if they recently had a tick bite or have been in an area where Lyme Disease is prevalent.

    The test is recommended when someone have been infected with Lyme Disease but doesn’t know the onset of the infection.

    Results are typically returned within 1 business days. We take every precaution to ensure you receive your results on time.

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    Cdc Supports The Development Of New Tests

    New tests may be developed as alternatives to one or both steps of the two-step process. Before CDC will recommend new tests, they must be cleared by the Food and Drug Administration . For more details, see: Recommendations for Test Performance and Interpretation from the Second National Conference on Serologic Diagnosis of Lyme Disease.

    What Is A Lyme Disease Blood Test

    A Lyme disease blood test is used to determine if you have contracted Borrelia burgdorferi , the bacterium that causes Lyme disease. Lyme disease tests are conducted with a routine blood draw.

    While there are other species of Borrelia that cause Lyme disease, B. burgdorferi is the most common cause in the United States. Most antibody tests in the United States only test for B. burgdorferi, but other species-specific tests are available depending on a persons travel history.

    Lyme disease is transmitted to humans through ticks that are infected with Borrelia.

    • dizziness
    • shortness of breath

    Lyme disease can be difficult to diagnose. Ticks are very small, and the bites are not always noticeable. Symptoms of the disease can vary from person to person. Not everyone experiences the classic bulls-eye rash pattern around a tick bite.

    It should be noted that testing is not always required to make a diagnosis. For people with a classic bulls-eye rash living in a high risk area, testing is not recommended for diagnosis.

    Your doctor will use the results of a Lyme disease antibody test, along with the report of your symptoms, to confirm a diagnosis.

    Antibodies are proteins your body makes in response to foreign or harmful substances called antigens. Common antigens include:

    • bacteria
    • fungi
    • chemicals

    If you have never been exposed to B. burgdorferi, you will not have any Lyme disease antibodies in your bloodstream. In this case, your test will be negative.

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    Question 10 What Other Infections Can A Tick Transmit To Humans Besides Lyme Disease

    I scapularis ticks can also carry other human pathogens that have a high degree of symptom overlap, including Borrelia miyamotoi, Anaplasma phagocytophilum, Ehrlichia chaffeensis, and Babesia microti.2,10-12 Several studies on co-infected ticks indicate as many as 20% of Ixodid ticks can be coinfected with B burgdorferi and one or more of these other tick-borne human pathogens.10-12

    Molecular tests can be useful to detect these organisms in early/acute stages of infection, when genetic material from the pathogen can be detected but antibodies remain below the limit of detection of serologic assays.2,10-12 Quest offers molecular and/or serological tests for B burgdorferi, B miyamotoi, A phagocytophilum, E chaffeensis, and B microti, individually and in 2 panels .

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    Early Signs And Symptoms

    Lyme Disease Testing What Your Doctor is Missing
    • Fever, chills, headache, fatigue, muscle and joint aches, and swollen lymph nodes
    • Erythema migrans rash:
    • Occurs in approximately 70 to 80 percent of infected persons
    • Begins at the site of a tick bite after a delay of 3 to 30 days
    • Expands gradually over a period of days reaching up to 12 inches or more across
    • May feel warm to the touch but is rarely itchy or painful
    • Sometimes clears as it enlarges, resulting in a target or bull’s-eye appearance
    • May appear on any area of the body

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    Lyme Disease Ab Quant Igm

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    Question 5 How Do The Sttt And Mttt Detection Methodologies Compare

    The MTTT appears to provide similar or improved sensitivity and specificity compared to the STTT. In a 356-sample retrospective study of a heterogenous cohort, specimens from healthy and disease control subjects and patients characterized as having stage I , stage II , or stage III Lyme disease were tested with both the STTT and MTTT approach.4 The results are summarized in Table 1. The MTTT methodology showed improved sensitivity relative to STTT for Lyme stages I and II, with statistically comparable sensitivity for stage III Lyme disease specificity did not differ significantly between the 2 methods.4

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    Standard Tests: Lyme Ab/western Blot Reflex

    The Centers for Disease Control and Prevention recommends a two-tiered test. First, you take an enzyme assay or an immunofluorescence assay . More specifically, you usually take an enzyme-linked immunosorbent assay . This screening test is the only Lyme test most PCPs order. Sadly, it has a low sensitivity rate.

    According to Lab Tests Online, DiagnosticSensitivity is the ability of a test to correctly identify people who have a given disease or disorder.

    In other words, a test with a low sensitivity rate will yield many false negatives. As a result, many people with Lyme go undiagnosed, allowing the bacteria to multiply.

    In the CDC process, if your screening test is positive or equivocal, only then will your PCP order the western blot. If the western blot is positive, you are then diagnosed with Lyme disease.

    For two reasons, I recommend you ask your doctor to order both tests right away:

    1. You wont have to wait for your screening test results before getting the western blot. Why is this important? Especially with Lyme, the quicker youre diagnosed and begin treatment, the better.

    2. You may test positive on the western blot, but negative on the screening test.

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    Lyme Disease Antibody Total Eia With Reflex To Antibodies Igg & Igm Western Blot

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