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Borrelia burgdorferi Antibody, IgM by Immunoblot (CSF)
0055258
Ordering Recommendation

Use in conjunction with serologic testing for the workup of suspected acute Lyme neuroborreliosis. Do not order in the absence of clinical symptoms.

Mnemonic
LYMEMWBCSF
Methodology
Qualitative Immunoblot
Performed
Sun-Sat
Reported
1-3 days
New York DOH Approval Status
Specimens from New York clients will be sent out to a New York DOH approved laboratory, if possible.
Submit With Order
ARUP Consult®
Disease Topics
Specimen Required
Patient Preparation
 
Collect
CSF. 
Specimen Preparation
Transfer 3 mL CSF to an ARUP Standard Transport Tube. (Min: 2 mL) 
Storage/Transport Temperature
Refrigerated. 
Unacceptable Conditions
Contaminated or heat-inactivated specimens. 
Remarks
 
Stability
Ambient: 8 hours; Refrigerated: 2 weeks; Frozen: 1 year (avoid repeated freeze/thaw cycles) 
Reference Interval
Effective August 15, 2011

Negative
Interpretive Data
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.

Compliance Statement B: This test was developed and its performance characteristics determined by ARUP Laboratories. The U.S. Food and Drug Administration has not approved or cleared this test; however, FDA clearance or approval is not currently required for clinical use. The results are not intended to be used as the sole means for clinical diagnosis or patient management decisions.

Note
A negative result indicates that the immunoblot evaluation for B. burgdorferi 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 Lyme 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 serologic diagnosis of Lyme disease are to screen with a polyvalent EIA test and confirm equivocal and positive with immunoblot.  Both IgM and IgG immunoblots should be performed on specimens obtained less than 4 weeks after appearance of erythema migrans.  Only IgG immunoblot should be performed on specimens 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.  Please submit requests for appropriate immunoblot testing within 10 days.
CPT Code(s)
86617
Components
Component Test Code*Component Chart NameLOINC
0055258Borrelia burgdorferi Ab, IgM, IB (CSF)13203-5
* 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.
Aliases
  • Lyme Disease
  • Lyme Disease IgM CSF WB
  • Lyme Disease IgM CSF Western Blot