Effective Monday, September 24, 2012, there will be a change in the ordering options for Lyme disease testing.  Instead of a single order option for Lyme disease serology testing, there will now be two options:

"LYME DISEASE ANTIBODIES (ACUTE DISEASE)"	[LAB7769]
"LYME DISEASE ANTIBODIES (LATE DISEASE)"	[LAB7770]

Both options start with ELISA testing for Lyme disease antibodies.

The early disease option is for patients who are being tested four weeks or less from erythema migrans or onset of disease symptoms.  In this option, positive or equivocal results are reflexed to Western blot IgG and IgM analysis.  Keep in mind that serological testing is not required for patients with erythema migrans as serological tests are likely to be negative at this stage of disease.

The late disease option is for patients who are more than four weeks from erythema migrans or onset of disease symptoms.  In this option, positive or equivocal results are reflexed to Western blot IgG only.

Ordering prompts in Epic will provide information distinguishing the two options.

This re-structuring of Lyme disease testing options follow Centers for Disease Control and Prevention (CDC) recommendations for the serologic diagnosis of Lyme disease.  In particular, studies have found that Western blot IgM testing does not aid in the diagnosis of neuroborreliosis or chronic Lyme disease and can potentially be misleading when ordered in the workup of chronic Lyme disease.

Epic order sets with the existing "LYME DISEASE ANTIBODY, IGG/IGM" [LAB2358] will have this test replaced with the two new Lyme disease testing options.

Questions should be directed to Matthew Krasowski, MD, PhD, medical director of the Clinical Chemistry Laboratory (384-9380, matthew-krasowski@uiowa.edu).