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.

Mnemonic
LYME G WB
Methodology

Qualitative Immunoblot

Performed

Sun-Sat

Reported

1-2 days

New York DOH Approval Status
This test is New York DOH approved.
Specimen Required
Patient Preparation
Collect

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

Refrigerated.

Unacceptable Conditions

CSF or plasma. Contaminated, heat-inactivated, hemolyzed, severely lipemic specimens.

Remarks
Stability

After separation from cells: Ambient: 48 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 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.

No compliance statements are in use for this test.

Note

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
N/A
CPT Codes

86617

Components
Component Test Code* Component Chart Name LOINC
0050252 B. burgdorferi IgG Immunoblot 6320-6
* 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.
Aliases
  • Lyme Antibody
  • Lyme Disease
  • Lyme Disease IgG WB
  • Lyme Disease IgG Western Blot
Borrelia burgdorferi Antibody, IgG by Immunoblot