Lyme Disease IgG, IgM Antibodies by Western Blot in CSF

Code
900.5740
Name
Lyme Disease IgG, IgM Antibodies by Western Blot in CSF
Category
None
Department
Send-Out
Start Date
Expiration Date
Synonyms
Lyme IgG IgM WB CSF, Lyme Abs WB CSF, Borrelia Burgdorferi Abs CSF
CPT Codes
86617x2
Site
SBMF
Reference Test
44728
ATLAS Test Code

Specimen Information

Type

Cerebrospinal Fluid (CSF)

Volume

3.0mL CSF

Transport Info

Refrigerated

Fasting Required?
False
Patient Instructions

Reference Range

Negative

Methodology

Qualitative Western Blot

Clinical Significance

IgG: For this assay, a positive result is reported when any 5 or more of the following 10 bands are present: 18, 23, 28, 30, 39, 41, 45, 58, 66, or 93 kDa. All other banding patterns are reported as negative.

IgM: For this assay, a positive result is reported when any 2 or more of the following bands are present: 23, 39, or 41 kDa. All other banding patterns are reported as negative.

The detection of antibodies to Borrelia burgdorferi in cerebrospinal fluid may indicate central nervous system infection. However, consideration must be given to possible contamination by blood or transfer of serum antibodies across the blood-brain barrier.

Note:
A negative result indicates that the Western blot evaluation for Borrelia burgdorferi antibody demonstrates no antibodies unique to Borrelia burgdorferi, and therefore is not supportive of Lyme disease.

A positive result indicates that the Western blot evaluation for Lyme antibody is consistent with the presence of antibody produced by patients in response to infection by Borrelia burgdorferi and suggests the presence of Lyme disease. Although the test has been shown to have a high degree of reliability for diagnostic purposes, laboratory data should always be correlated with clinical findings.

Current CDC recommendations for the serological diagnosis of Lyme disease are to screen with a polyvalent ELISA test and confirm equivocals and positives with Western blot. Both IgM and IgG Western blots should be performed on samples obtained less than four weeks after appearance of erythema migrans. Only IgG Western blot is to be performed on samples greater than four weeks after disease onset. IgM Western blot in the chronic stage is not recommended and does not aid in the diagnosis of neuroborreliosis or chronic Lyme disease.

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