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
Methodology
Qualitative Immunoblot
Performed
Sun-Sat
Reported
1-3 days
New York DOH Approval Status
Specimen Required
CSF.
Transfer 3 mL CSF to an ARUP Standard Transport Tube. (Min: 2 mL)
Refrigerated.
Bacterially contaminated, heat-inactivated, hemolyzed, or xanthochromic specimens.
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.
This test was developed and its performance characteristics determined by ARUP Laboratories. It has not been cleared or approved by the US Food and Drug Administration. This test was performed in a CLIA certified laboratory and is intended for clinical purposes.
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
CPT Codes
86617
Components
Component Test Code* | Component Chart Name | LOINC |
---|---|---|
0055258 | Borrelia burgdorferi Ab, IgM, IB (CSF) | 13203-5 |
Aliases
- Lyme Disease
- Lyme Disease IgM CSF WB
- Lyme Disease IgM CSF Western Blot