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.
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, heat-inactivated, or hemolyzed 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 Category

Modified FDA

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.

Hotline History
N/A
CPT Codes

86617

Components
Component Test Code* Component Chart Name LOINC
0055258 Borrelia 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
Borrelia burgdorferi Antibody, IgM by Immunoblot (CSF)