Patients with other spirochetal disease and/or who test positive for rheumatoid factor or Epstein Barr virus may have cross-reacting antibodies and may have positive results for 31, 41, and/or 83 kDa antigens. Positive or equivocal first-tier test results should not be reported until second-tier testing of the specimen is performed using a method that is more specific, such as Western Blot/ ImmunoBlot. The evaluation must include all test results, the clinical history presented by the patient, the patient’s exposure to endemic regions for Lyme disease, epidemiological data, and any potential exposure to other spirochetal diseases. In active syphilis, the VDRL and RPR are positive, and in Lyme disease they are not. Active syphilis and Lyme disease can be differentiated by the use of VDRL or RPR tests. In cases where false positive results occur, clinical epidemiological and laboratory workups should be carried out. Sera from patients with mononucleosis or lupus erythomatosis (LE) may also give false positive results. Sera from patients with other pathogenic spirochetal diseases such as syphilis, yaws, pinta, leptospirosis, and relapsing fever may give false positive results. burgdorferi Western Blots or Lyme ImmunoBlots. Therefore, this test is recommended approximately 2 weeks after suspected exposure to Lyme.Īll samples with positive or equivocal results should be tested with B. Though the level of IgM declines over time, the IgM response may persist in patients with prolonged illness, and a new IgM response may appear later in persistent or recurrent disease or from re-infection. IgM antibodies appear early in response to infection therefore, this test may be positive between 2 to 6 weeks after exposure. burgdorferi after possible exposure to an infected tick. The Lyme IgM antibody ELISA is a serological test for the detection of IgM antibodies to B. NOTE: The sensitivity concerns mentioned for the IgG/IgM assay also affect this assay.īorrelia burgdorferi Antibody Serology IgM But since the level of IgM rapidly declines over time, testing for IgM antibodies too late can cause a missed infection.Ī positive or equivocal IgM antibody test must be confirmed by an IgM Western Blot or Lyme ImmunoBlot IgM. Because IgM antibodies appear early in response to infection, this test may be positive two to six weeks after exposure. burgdorferi after exposure to an infected tick. The IgG/IgM Antibody Serology test is an ELISA (enzyme linked immunoassay) format, and it detects the presence of IgM antibodies to B. The use of this assay has not been evaluated for individuals who have received a Lyme disease vaccine. The evaluation must include a review of all test results, the clinical history presented by the patient, the patient’s exposure to endemic regions for Lyme disease, epidemiological data, and potential exposure to other spirochetal diseases. Retesting may be warranted if symptoms consistent with Lyme disease persist. Negative results early in the disease have a low predictive value. Antibiotic therapy given early in the disease may prevent the development of an antibody response. In active syphilis, the VDRL and RPR are positive, whereas in Lyme disease they are not. In cases where false-positive results occur, clinical epidemiological and laboratory workups should be carried out. 
Sera from patients with mononucleosis or lupus erythomatosis (LE) may also give false-positive results.Sera from patients with other pathogenic spirochetal diseases such as syphilis, yaws, pinta, leptospirosis, and relapsing fever may give false-positive results.
This test should only be performed in conjunction with Western Blots/ ImmunoBlots.The percentage of patients with a positive serology is reduced in subsequent years.Īll samples with positive or equivocal results should be tested with B. Patients diagnosed with Lyme disease based on clinical history have positive IgG/IgM serology results within one year of the tick bite, approximately 70% of the time. This test is recommended at least four weeks after exposure. A positive or equivocal test must be confirmed by both IgG and IgM ImmunoBlots Blots.īorrelia burgdoferi Antibody Serology IgG/IgM The presence of either IgG/IgM antibodies indicates exposure to Lyme-causing Borrelia, not the active disease. IgG antibodies often persist long after symptoms have disappeared. IgM antibodies are present shortly after infection takes place. The IgG/IgM Antibody Serology test is an ELISA (enzyme linked immunoassay), which indicates the presence of both IgG and IgM antibodies to B.
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