Borrelia burgdorferi Antibody, IgG by Immunoblot
Ordering Recommendation

Do not order in the absence of a positive/equivocal ELISA screening test. During first 4 weeks of clinical symptoms, order concurrent IgM immunoblot.

Qualitative Immunoblot
1-2 days
New York DOH Approval Status
This test is New York DOH approved.
Submit With Order
ARUP Consult®
Disease Topics
Specimen Required
Patient Preparation
Serum separator tube. 
Specimen Preparation
Separate serum from cells ASAP or within 2 hours of collection. Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 0.1 mL) 
Storage/Transport Temperature
Unacceptable Conditions
CSF or plasma. Contaminated, heat-inactivated, hemolyzed, severely lipemic specimens. 
After separation from cells: Ambient: 48 hours; Refrigerated: 2 weeks; Frozen: 1 year (avoid repeated freeze/thaw cycles) 
Reference Interval
Effective August 15, 2011

Interpretive Data
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.

This test should be used for confirmation of an equivocal or positive B. burgdorferi Total Antibodies, IgG and/or IgM test performed on patients greater than 4 weeks after disease onset. A negative result indicates that the immunoblot evaluation for the Lyme antibody demonstrates no antibodies unique to B. burgdorferi and is, therefore, not supportive of Lyme disease.

A positive result indicates that the immunoblot evaluation for B. burgdorferi antibody is consistent with the presence of antibody produced by patients in response to infection by B. 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 immunoblot. Both IgM and IgG immunoblots should be performed on samples obtained less than 4 weeks after appearance of erythema migrans. Only IgG immunoblot is to be performed on samples greater than 4 weeks after disease onset. IgM immunoblot in the chronic stage is not recommended and does not aid in the diagnosis of neuroborreliosis or chronic Lyme disease.
Hotline History
Component Test Code*Component Chart NameLOINC
0050252B. burgdorferi IgG Immunoblot6320-6
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.
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