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Western Blot Assay For Lyme Disease

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What Bands Are Positive For Lyme

Lyme Disease: POSITIVE IGM Western Blot Test (2013)

Some Lyme specialists and scientists believe that there are five very specific bands on the Western blot test that are highly indicative of Lyme disease: band numbers 23, 31, 34, 39 and 93. If any of these bands are positive and the patient is experiencing symptoms of Lyme disease, they may feel treatment is warranted.

Lyme Disease Blood Test Results Fully Explained

The Lyme disease blood test is used to discover if someone who has the symptoms of a Borrelia burgdorferi infection actually has the bacteria in their bloodstream. Recent infections are much easier to detect and an IgM and IgG blood test will often be ordered as complimentary information gathering tools. This blood test does not always detect the presence of the disease, so patients that have persistent symptoms after having the test may be re-tested in a few weeks.

If any of these tests come back as positive, then other samples will be used to track the stage of the disease to determine if it has reached the chronic infection stage. At this point, a medical provider will order a Western blot test to confirm the presence of Lyme disease.

The Best Test For Lyme Disease

Lyme disease is a tick-borne illness spread by Lyme borreliaebacteria which includes, but is not limited to, Borrelia burgdorferi sensu stricto. The Centers for Disease Control and Prevention estimate that there are 400,000 cases of Lyme disease annually, making Lyme a serious public health concern that only stands to grow as the spread of ticks affects disease endemicity and seasonality.

One of the biggest challenges of fighting Lyme disease is providing patients with accurate diagnostic tests. Without access to the best tests for Lyme disease, its impossible to diagnose this treatable disease in a timely manner. When the disease isnt caught in time, it can spread throughout the body and cause chronic health problems that could otherwise be avoided with earlier detection and treatment.

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What Is The Most Reliable Lyme Disease Test

There is no one answer when it comes to determining which Lyme disease test is the most reliable. This is because each test looks for a different thing at a different stage of the infection. When investigating a long-term infection, tests that look for the bodys response to the infection are the most reliable, whereas for an active infection, a test that identifies the bacteria itself will be the most effective. Some tests only show up on an active infection and fail to indicate chronic Lyme, so the most reliable test option depends on which stage a persons infection is currently at.

Featured image by Emin Baycan on Unsplash

Can Lyme Disease Be Detected By A Blood Test

PPT

In a word: yes!

A blood test does not only detect Lyme disease it is the most accurate and preferred test for diagnosing the disease. If a patient with Lyme disease shows signs that the central nervous system has been affected by the disease, western blot testing on the cerebrospinal fluid can be performed. If ordering from Walk-In Lab, a doctors note is not needed. Just pick your Lyme disease test and place your order online.

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Lyme Disease Test Western Blot

Labs performing a Western blot use electricity to separate proteins called antigens into bands. The read-out from the Western blot looks like a bar code. The lab compares the pattern produced by running the test with your blood to a template pattern representing known cases of Lyme disease. If your blot has bands in the right places, and the right number of bands, it is positive.

The CDC requires 5 out of 10 bands for a positive test result. However, because some bands on the Western blot are more significant than others your doctor may decide you have Lyme disease even if your Western blot does not have the number of bands or specific bands recommended by the CDC. Different laboratories use different methods and criteria for interpreting the test, so you can have a positive test result from one lab and a negative test result from another.

For a comprehensive explanation of the western blot test, download Understanding Western Blot Lyme disease test.

The chart below will help you understand how to interpret the western blot test.

What Do The Test Results Mean

Because there are three tests that are typically conducted for the Lyme disease blood test, then results can vary based on the combination of test results received. When all three tests are positive, then Lyme disease is likely. These other result combinations are usually interpreted in the following ways.

Positive IgM, Negative IgG, Negative Western Blot.This usually indicates that the Lyme disease infection is in its early stages or that the blood test has produced a false positive result.

Negative IgM, Positive IgG, Positive Western Blot.This is usually interpreted as having a late-stage Lyme disease infection. It may also be an indication that someone had a previous infection that has been removed from the body.

All results negative.This is usually interpreted as there not being any infection present and that the symptoms are being caused by another issue. In some specific instances, however, it can also be seen as the antibody levels being too low to detect.

Once Lyme disease is confirmed, there will almost always be detectable levels of the bacteria which causes the disease in the IgG antibodies in their blood. This will mean that their IgG blood test results will have a standard deviation in what is considered as normal because of the presence of the disease, even if it has been effectively cured.

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Important: Dont Misinterpret A Negative Test As Positive

Many people without Lyme disease will test positive for some bands. Therefore, the CDC cautions:

It is not correct to interpret a test result that has only some bands that are positive as being mildly or somewhat positive for Lyme disease.

For example, in one study, 43% of healthy people and 75% of syphilis patients tested positive for IgG band 41. In a study of US veterans in New York, 76% of those without Lyme disease tested positive for IgG band 41. In a 1996 study, in healthy people, 55% and 21% tested positive for IgG band 41 and IgM band 41, respectively.

Even without a Borrelia burgdorferi infection, many of us produce antibodies that will react on a Lyme test. Notably, harmless bacteria found naturally in our mouths can cause us to test positive for band 41.

A positive Lyme antibody test requires both tiers to be positive, as many without Lyme infections can test positive on single tests. For example, one study found up to 40% of patients with Lupus and other rheumatic diseases test positive on the first tier ELISA test. The second tier test is necessary to stop a false positive diagnosis.

The American Society for Microbiology recommends against ordering the Western blot without a positive ELISA screening:

The Lyme immunoblot test is designed only as a confirmatory test, so it is important not to test screen-negative samples.

LymeScience recommends against:

Table excerpted and reformatted*** from the longer 2013 paper :

High Endemicity Screening Of A Child

The Western Blot Test And Lyme

A healthy child from an area of high endemicity receives an annual physical. The mother notes that the child enjoys playing in the backyard, which is adjacent to a heavily wooded area.

Serologic testing should not be ordered because the child is asymptomatic. A false-positive test result would expose the child unnecessarily to the risks of treatment. In this scenario, the probability that a positive test represents true infection is less than 25 percent.

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Traditional Lyme Disease Tests Are Not Specific Enough

Lyme disease is caused by the spiral-shaped bacteria Borrelia. There are multiple species and strains of Lyme borreliae . Therefore, tests must be targeted to these multiple species and strains in order to be able to detect them. If a patient is infected with a species or strain of Lyme borreliae that their test cant detect, they will get a false-negative test result and thus risk missing their diagnosis. This can be costly and dangerous.

Many ELISA and Western blot Lyme disease tests are only equipped to detect one strain of one species of Borrelia: Borrelia burgdorferi B31 . This means that those tests are missing infections caused by other strains and/or species of Lyme borreliae.

In one internal study designed to test the validity of the IGeneX ImmunoBlot against traditional Western blot tests, a total of 132 patients were tested by both Lyme Western blots and Lyme IB. 43 patients were seropositive on the ImmunoBlot, and 14 were positive on standard Western blots prepared from a mixture of two species for Bb ss B31 and 297. Thus 29 of the 43 patients tested negative on Western blots i.e., the Western blot totally missed their infections with strains other than Bb ss B31 and 297.

With such limited tests, patients infected with non-B31 species and strains e.g., B. mayonii, B. californiensis, or European species are at risk of receiving false negatives and missing the chance to treat their diseases.

What You Should Know About Lyme Disease

If the symptoms of Lyme disease persist and there is no known cause for them, then consulting with a Lyme literate doctor may provide treatment progress. Many health insurance plans will not cover these consultations or tests, however, so proceed with caution.

For those who are treated with antibiotics, a condition called PTLD occurs that mimics the symptoms of the disease for up to 6 months.

In regions where Lyme disease is not prevalent, it is usually up to the patient to insist on receiving the Lyme disease blood test. Use this guide to speak with your doctor about your concerns and discuss what the results may mean for your health.

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Confirming Lyme Diagnosis With Western Blot Lyme Test

Lyme disease is a medical condition caused by a bacterial infection and is often difficult to diagnose, because it mimics a variety of other health conditions. To further complicate the matter, the tick that spreads this infection can cause other infections as well, not just Lyme disease.

Luckily, there are laboratory tests that can help aid in the diagnosis. Lab tests identify antibodies from the bacteria and are more accurate if done a few weeks after the infection. ELISA and IFA are the most common lab tests done to detect antibodies to Borrelia Burgdorferi, the bacteria that causes Lyme. However, these tests can sometimes give a false positive result. In order to confirm the diagnosis of Lyme, another test called the Western blot lyme test is ordered. PCR is another test that can detect the DNA of the bacteria by using a sample from the joint fluid of patients with chronic arthritis associated with Lyme. A sample from cerebrospinal fluid can be tested if the patients symptoms are affecting the nervous system.

The Role Of Lyme Disease Tests

When Life Gives You Lyme: ELISA &  Western Blot Tests for ...

The purpose of the most common type of Lyme disease testing is to determine whether you have developed antibodies as a result of past exposure to the Borrelia bacteria that cause Lyme disease. Antibodies are proteins created by the immune system that target specific threats like bacteria and viruses.

Blood testing alone cannot determine whether you have Lyme disease. Instead, testing can provide helpful information that your doctor can consider along with other factors, such as any symptoms youve had and whether youve been exposed to ticks that can carry Borrelia, to determine if a diagnosis of Lyme disease is appropriate.

Beyond blood testing, it is possible to analyze fluid from the central nervous system for signs of the Borrelia bacteria.

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Western Blot Lyme Test: What It Is And How To Read It

Lyme disease is a medical condition caused by a bacterial infection and is often difficult to diagnose, because it mimics a variety of other health conditions. To further complicate the matter, the tick that spreads this infection can cause other infections as well, not just Lyme disease.

Luckily, there are laboratory tests that can help aid in the diagnosis. Lab tests identify antibodies from the bacteria and are more accurate if done a few weeks after the infection. ELISA and IFA are the most common lab tests done to detect antibodies to Borrelia Burgdorferi, the bacteria that causes Lyme. However, these tests can sometimes give a false positive result. In order to confirm the diagnosis of Lyme, another test called the Western blot test is ordered. PCR is another test that can detect the DNA of the bacteria by using a sample from the joint fluid of patients with chronic arthritis associated with Lyme. A sample from cerebrospinal fluid can be tested if the patients symptoms are affecting the nervous system.

Western Blot Test

While the ELISA/IFA are quantitative tests, the Western blot provides qualitative data. The newest version of the western blot test to detect Lyme disease is called Immuonoblot. The results will look like a bar code, with lines called bands. Each band corresponds to antibodies of different components of the bacterium Borrelia Burgdorferi. The combination of specific bands will help identify if the bacterium is indeed Borrelia.

References:

Diagnosis Of Lyme Disease

DANIEL L. DEPIETROPAOLO, M.D., Christiana Care Health Services, Wilmington, Delaware

JOHN H. POWERS, M.D., National Institutes of Health, Bethesda, Maryland

JAMES M. GILL, M.D., M.P.H., and ANDREW J. FOY, Christiana Care Health Services, Wilmington, Delaware

Am Fam Physician. 2005 Jul 15 72:297-304.

Patient information: See related handout about Lyme disease, written by the authors of this article.

Lyme disease is a systemic illness resulting from infection with the spirochete Borrelia burgdorferi.1 According to the Centers for Disease Control and Prevention definition for reportable cases of Lyme disease, the annual number of cases increased from 7,943 in 1990 to 17,730 in 2000.2,3 The disease is most prevalent in children two to 15 years of age and in adults 30 to 59 years of age.3Figure 14 shows the endemicity of Lyme disease in areas of the United States.

SORT: KEY RECOMMENDATIONS FOR PRACTICE

Physicians should assess the pretest probability of a patient with suspected Lyme disease on the basis of clinical signs and symptoms and the likelihood of exposure.

A = consistent, good-quality patient-oriented evidence B = inconsistent or limited-quality patient-oriented evidence C = consensus, disease-oriented evidence, usual practice, expert opinion, or case series. For information about the SORT evidence rating system, see page 209 or.

SORT: KEY RECOMMENDATIONS FOR PRACTICE

Figure 1.

Figure 1.

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What Does It Mean If Your Lyme Disease Ab Blot Result Is Too High

Two types of antibodies are detected in the Western blot test.

IgM antibodies reflect a relatively recent infection. IgG antibodies in contrast are a sign of an older infection.

IgM antibodies usually disappear after eight weeks post-exposure. IgG remains in the serum for a very long time.

In the Western blot test there are three bands for IgM and 10 bands for IgG.

Here is the important part:

– You need to have 2 out of 3 for the positive IgM result

– Or you need to have 5 out of 10 for the positive IgG result.

This marker is called Lyme Disease AB , Blot and is an aggregate marker for the three IgM results. So if this marker is positive you have at least 2 out of 3 of the IgM markers positive.

Here is the 2nd important part when it comes to a diagnosis:

If a person doesn’t have signs or symptoms of Lyme disease, then the person does not have Lyme disease as the definition of disease requires symptoms.

What could some of those symptoms be?

What are the symptoms of Lyme disease?

Lyme disease symptoms are wide-ranging, with more than a hundred different symptoms recorded. Symptoms can also change over time, as the bacteria spreads throughout the body. To make things more confusing, Lyme disease symptoms will also vary from patient-to-patient. Lyme disease can mimic hundreds of other conditions since its symptoms mirror many medical problems such as multiple sclerosis, arthritis, chronic fatigue syndrome or lupus, and is sometimes known as The Great Imitator because of this.

What Is A Lyme Disease Blood Test

Lyme Disease = The Great Imitator & Western Blot Test Info

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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