Borrelia burgdorferi Antibodies, IgG & IgM by Western Blot (CSF)
0055260
Ordering Recommendation
Use in conjunction with positive serologic testing for the workup of suspected acute Lyme neuroborreliosis. Do not order in the absence of clinical symptoms.
Mnemonic
LYME WBCSF
Methodology
Qualitative Western Blot
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
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
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.

See Compliance Statement B: www.aruplab.com/CS
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 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.
CPT Code(s)
86617 x2
Components
Component Test Code*Component Chart NameLOINC
0055258Borrelia burgdorferi Ab, IgM, WB (CSF)13203-5
0055259Borrelia burgdorferi Ab, IgG, WB (CSF)13202-7
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Aliases
  • Lyme Disease
  • Lyme Disease Antibodies (CSF)
  • Lyme Disease CSF Ab Western Blot