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University of Iowa Diagnostic Laboratories (UIDL) Test Directory 319-384-7212 (local) 1-866-844-2522 (toll free) |
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| Borrelia burgdorferi Antibodies (Lyme) IgG & IgM | Order Code: LYME
Order Form: Laboratory Requisition |
Specimen: |
Serum | ||
Collection Medium: |
| ||
Minimum: |
2 ml; red top tube (no additive) | ||
Testing Schedule: |
Test is performed twice weekly. | ||
Analytic Time: |
3 days | ||
Reference Range: |
Negative | ||
Test Limitations: |
This test is a qualitative enzyme-linked fluorescent immunoassay (ELFA) for the presumptive detection of antibodies (IgG and IgM) to Borrelia burgdorferi to aid in the diagnosis of Lyme disease. Lyme disease is caused by infection with a tick-borne spirochete, B. burgdorferi, and is endemic in at least 15 states (1). The diagnosis of Lyme disease is based on clinical findings, exposure history, and antibody production (1). A two test approach is recommended for the serologic diagnosis of Lyme disease (2). Specimens are first tested with the more sensitive screening EIA. Specimens that are positive or equivocal will automatically be sent to the University Hygienic Laboratory for confirmatory testing with the more specific IgG and IgM Western blot. Positive EIA results should be considered presumptively positive and should not be used to make therapeutic decisions. Negative EIA results will be reported accordingly and no further testing will be performed. The sensitivity and specificity of the serologic tests vary in relation to the length of time since exposure (2). In early disease, a serologic response may not be detectable. Patients who receive antimicrobial therapy during the early stages of infection may not produce detectable levels of antibodies (3). False positive EIA results can occur in patients with syphilis, relapsing fever, Rocky Mountain Spotted Fever, other spirochetal diseases, autoimmune disease, rheumatoid arthritis, systemic lupus erythematosus, EBV or CMV infection (4). Clinical symptoms, epidemiology, and other laboratory tests such as the more specific Western blot should allow these conditions to be distinguished from Lyme disease. References 1. Steere AC. 2001. Medical progress: Lyme disease. New Eng J Med 345:115-125. 2. CDC. 1996. Recommendation for test performance and interpretation from the Second National Conference on Serological Diagnosis of Lyme Disease. MMWR 45:481-484. 3. Callister SM, KL Case, RF Schell. 1990. Diagnostic testing for Lyme disease. Labmedica Feb/March 11-14. 4. Magnarelli L, et al. 1987. Cross reactivity in serologic tests for Lyme disease and other spirochetal infections. J Infect Dis 156:183-188. | ||
Methodology: |
Enzyme-Linked Fluorescent Immunoassay (ELFA) | ||
Sample Processing: |
Label transport tube with two patient identifiers, date and time of collection. Aliquot serum into labeled container and cap. Centrifuge at 3000 RPM for 10 minutes. Centrifuge within one hour of draw time. | ||
Sample Storage: |
Refrigerate serum 2-8 degree C. | ||
Transport Instructions: |
Place requisition into outside pocket of bag. Place specimen into zip-lock type bag, seal bag. Use refrigerated coolant packs. | ||
CPT Code: |
86618 | ||
See Additional Information: Microbiology Specimen Collection and Transport |
Updated: 06/06/2007