Borrelia Burgdorferi (Lyme Disease)—Antibody Screen

Definition

• A sensitive serum serology screening test for the detection of IgG and/or IgM antibodies to Borrelia burgdorferi.

Use

• This test is used if Lyme disease is suspected in at-risk patients. Testing is not necessary if a patient presents with a tick bite and erythema migrans.

Interpretation

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Note: Current CDC recommendations state that equivocal and positive results should be confirmed with Western blot prior to reporting screen results. If testing is negative, consider other tick-borne diseases (i.e., Babesia, Ehrlichia). пїЅ пїЅ

Limitations

• Should not be used to screen general population. False-negative results can occur if the patient is tested too early; repeat testing in 2 " пїЅ4 weeks. The IgG antibody response is usually not detectable until 4 " пїЅ6 weeks after infection; the IgM antibody response usually not detected during the first 2 weeks of infection, peaking 3 " пїЅ6 weeks following infection. False-positive results may occur from other spirochetal diseases, autoimmune diseases, or other infections (EBV, HIV, syphilis, infectious mononucleosis, etc.). IgG antibodies can be detected as early as 2 weeks, and both IgM and IgG antibodies can remain detectable for years. Diagnosis depends on clinical features, combined with available laboratory tests.

Suggested Reading

1FDA Public Health Advisory: Assays for Antibodies to Borrelia burgdorferi; Limitations, Use, and Interpretation for Supporting a Clinical Diagnosis of Lyme Disease. July 7, 1997. http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/PublicHealthNotifications/UCM062429