Lyme Disease Ab with Reflex to Blot (IgG, IgM)

The Lyme Disease Ab with Reflex to Blot (IgG, IgM) test contains 1 test with 1 biomarker.

Brief Description: The Lyme Disease Antibody (Ab) with Reflex to Blot test is a two-step laboratory test used to detect antibodies produced by the body in response to the bacterium Borrelia burgdorferi, which causes Lyme disease. This test helps in the diagnosis of Lyme disease, a tick-borne illness that can lead to a range of symptoms affecting various body systems.

The reflex to blot occurs when the initial screening test is positive or equivocal. In such cases, the reflex test is automatically performed to confirm the presence of antibodies to Borrelia burgdorferi.

If Lyme Disease Antibody Screen is ≥0.90, then Lyme Disease Antibodies (IgG, IgM), Immunoblot will be performed at an additional charge of $63

Also Known As: Borrelia burgdorferi Test, Lyme Disease Antibodies IgG IgM Immunoblot Test, Lyme Disease antibodies Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a Lyme Disease Antibody test ordered?

When a person shows signs and symptoms of Borrelia infection and lives in or has visited a place where deer ticks, also known as black-legged ticks, are abundant, especially if the person has recently been bitten by a tick, Lyme disease testing is required.

Testing may be repeated after a few weeks if initial testing is negative but the suspicion of Lyme disease remains strong.

When a person does not have typical Lyme disease symptoms or a history of tick bites, and has not traveled to a Lyme disease-endemic area, a healthcare provider may rule out alternative possibilities before diagnosing and testing for Lyme disease.

What does a Lyme Disease Antibody blood test check for?

The bacteria Borrelia burgdorferi and Borrelia mayonii, which are transported predominantly by the deer tick, often known as the black-legged tick, cause Lyme disease. Borrelia antibodies in the blood are measured in Lyme disease tests.

The body's immune system produces these antibodies in reaction to exposure to Borrelia, the organism that causes Lyme disease. Infected deer ticks or black-legged ticks bite humans and transfer the bacterium. In areas where these ticks reside, such as the northeastern, mid-Atlantic, and midwestern United States, the disease is most common in the spring and summer.

A distinctive erythema migrans or "bulls-eye" rash that develops from the bite site, fever, chills, headache, and exhaustion are all indications of Lyme disease infection. Lyme disease can progress to cause intermittent joint pain and swelling, facial paralysis, weakening and numbness in the arms and legs, meningitis, memory issues, and in rare cases, heart and vision problems if left untreated.

It takes time for the immune system to produce antibodies against Borrelia. Two types of antibodies can be detected using laboratory tests. IgM antibodies are normally evident two to three weeks after the commencement of infection, while IgG antibodies are seen several weeks later.

Lab tests often ordered with a Lyme Disease Antibody test:

When a Lyme Disease Antibody test is ordered, it's often part of a broader evaluation of symptoms suggestive of Lyme disease and to rule out other conditions. Here are some tests commonly ordered alongside it:

  1. Complete Blood Count (CBC) with Differential:

    • Purpose: To evaluate overall blood health, including red and white blood cells, and platelets.
    • Why Is It Ordered: To assess for signs of infection or inflammation that might accompany Lyme disease or to rule out other causes of the patient's symptoms.
  2. C-Reactive Protein (CRP) or Erythrocyte Sedimentation Rate (ESR):

    • Purpose: Non-specific markers of inflammation.
    • Why Is It Ordered: To assess for inflammation, which can be elevated in Lyme disease and other infectious or inflammatory conditions.
  3. Urinalysis:

    • Purpose: To analyze various components of the urine.
    • Why Is It Ordered: To assess overall kidney function and to rule out urinary tract infections or kidney diseases that may present with similar symptoms.
  4. Liver Function Test:

    • Purpose: To assess liver health.
    • Why Is It Ordered: To rule out liver diseases, as some symptoms of Lyme disease can overlap with symptoms of liver disorders.
  5. Tick-borne Disease Testing such as Ehrlichiosis and Babesiosis:

    • Purpose: To test for other diseases that ticks can transmit.
    • Why Is It Ordered: To consider other tick-borne diseases that can co-occur with Lyme disease or present with similar symptoms.
  6. Rheumatoid Factor (RF) and Anti-Cyclic Citrullinated Peptide (Anti-CCP) Antibodies (if joint pain is a prominent symptom):

    • Purpose: To test for markers associated with rheumatoid arthritis.
    • Why Is It Ordered: To differentiate Lyme arthritis from rheumatoid arthritis, particularly in chronic cases.

These tests, when ordered alongside a Lyme Disease Antibody test, provide a comprehensive view of the patient’s condition and can help diagnose Lyme disease, assess its severity, and rule out other conditions with similar presentations. The specific combination of tests will depend on the individual’s symptoms, exposure history, and clinical presentation.

Conditions where a Lyme Disease Antibody test is recommended:

A Lyme Disease Ab with Reflex to Blot test is necessary when there is suspicion of Lyme disease due to symptoms or tick exposure. Lyme disease can manifest with a wide range of symptoms, and early detection is crucial for prompt treatment.

How does my health care provider use a Lyme Disease Antibody test?

Lyme disease tests are performed to see if a person has been infected with the germs Borrelia burgdorferi or Borrelia mayonii and has the symptoms of the disease. Antibodies generated by the immune system in response to infection are detected by the tests.

IgM and IgG antibodies can be detected via laboratory tests.

Antibodies to Borrelia IgM are frequently present in the blood two to three weeks after exposure. IgM concentrations peak about six weeks and then start to drop.

IgG antibodies are not detectable for many weeks after exposure, peak at four to six months, and can last for several years.

To identify these antibodies and confirm a diagnosis of Lyme disease, the Centers for Disease Control and Prevention recommends using two alternative procedures. The initial test is designed to be extremely sensitive in order to detect as many Lyme disease cases as possible. When a person does not have Lyme disease but does have another condition, such as another tick-borne disease, syphilis, or an autoimmune ailment like lupus, it may be positive. If the initial test yields a positive result, a second test using a different method is done to validate the findings. 

Lyme disease can be difficult to diagnose at times. If a person has removed a tick from his or her skin, has had a known tick bite, and lives in or has visited an area of the country where Lyme disease is common, the timing of the probable infection can be accurately predicted. However, because the tick is about the size of a pinhead, the bite may go unnoticed. Not everyone will get the rash, and the symptoms that do occur may be nonspecific and flu-like in the beginning, with joint pain that progresses to chronic arthritis and/or neurological problems that appear months later.

What do my Lyme Disease antibody test results mean?

Antibodies are not produced in a healthy adult who has never been infected with Borrelia germs.

If a person exhibits signs and symptoms, as well as positive EIA or IFA and western blot tests, it is likely that they have Lyme disease.

If a person tests positive for IgM antibody but negative for IgG and western blot, they may have had a recent infection or a false-positive test result.

If an IgM result is undetectable but the IgG and Western blot tests are positive, the person examined is likely to have a later stage infection or to have had an infection previously.

If all tests come out negative, the person's symptoms are either caused by something else or the antibody levels are too low to detect at that time; retesting in 2 to 3 weeks may be required to confirm or rule out infection.

If the IgM and western blot are negative but the IgG is positive, the person has either recovered from Lyme disease or the symptoms are due to cross reactive antibodies plus something else.

Most Common Questions About the Lyme Disease Ab with Reflex to Blot test:

Understanding the Lyme Disease Ab with Reflex to Blot Test

What is the Lyme Disease Ab with Reflex to Blot test?

The Lyme Disease Ab with Reflex to Blot test, also known as the Lyme disease serology with reflex to Western Blot test, is a two-step laboratory test used to detect antibodies against Borrelia burgdorferi, the bacteria that cause Lyme disease.

Why would a healthcare provider order the Lyme Disease Ab with Reflex to Blot test?

A healthcare provider would order this test if a patient shows symptoms of Lyme disease and has been in an area known to have ticks that carry Borrelia burgdorferi. These symptoms could include fever, headache, fatigue, and a characteristic skin rash called erythema migrans.

How does the Lyme Disease Ab with Reflex to Blot test contribute to understanding my overall health?

This test can contribute to understanding your overall health by helping to diagnose Lyme disease, which can affect multiple systems in the body if left untreated. Early diagnosis and treatment can prevent complications such as joint, heart, and nervous system problems.

Interpreting Lyme Disease Ab with Reflex to Blot Test Results

What does a positive result on the Lyme Disease Ab with Reflex to Blot test mean?

A positive result means that antibodies to Borrelia burgdorferi were detected, which suggests a current or past infection with the bacteria that cause Lyme disease.

What does a negative result on the Lyme Disease Ab with Reflex to Blot test mean?

A negative result means that antibodies to Borrelia burgdorferi were not detected. This could indicate that the person tested has not been infected with Lyme disease, or it could mean that the infection is too recent for antibodies to have developed.

How is the reflex part of the Lyme Disease Ab with Reflex to Blot test interpreted?

If the initial test (the enzyme immunoassay) is positive or equivocal, the sample is then tested with a Western Blot for confirmation. The Western Blot can provide more specific information about the antibodies detected, helping to avoid false positive results.

Can the Lyme Disease Ab with Reflex to Blot test distinguish between current and past infection?

The test can sometimes provide clues about the timing of infection based on the types of antibodies present, but it can't definitively distinguish between current and past infection. The presence of IgM antibodies usually indicates a recent infection, while the presence of IgG antibodies suggests past infection.

Lyme Disease Ab with Reflex to Blot Test and Specific Health Conditions

Can the Lyme Disease Ab with Reflex to Blot test be used to monitor treatment for Lyme disease?

This test is not typically used to monitor treatment because antibody levels can remain high for months or even years after successful treatment. Clinical symptoms are usually a better indicator of treatment success.

Can the Lyme Disease Ab with Reflex to Blot test diagnose other diseases caused by tick bites?

The test is specific for antibodies to Borrelia burgdorferi and is not designed to diagnose other tick-borne diseases. However, other tests can be used to diagnose diseases such as babesiosis, ehrlichiosis, and anaplasmosis.

How is the Lyme Disease Ab with Reflex to Blot test used in managing patients with neurological symptoms?

In patients with neurological symptoms suggestive of Lyme disease, such as facial palsy or meningitis, this test can provide valuable information. If the test is positive, it may suggest that the symptoms are due to Lyme disease.

The Lyme Disease Ab with Reflex to Blot Test and Lifestyle

Can the Lyme Disease Ab with Reflex to Blot test be used to assess risk after a tick bite?

If a person is bitten by a tick in an area where Lyme disease is prevalent, this test can be used to determine whether they have been infected. However, the test is usually only recommended if symptoms of Lyme disease develop, as the body may not produce detectable antibodies immediately after a tick bite.

Can the Lyme Disease Ab with Reflex to Blot test assess the effectiveness of prevention strategies? The test does not directly assess the effectiveness of prevention strategies such as tick checks or insect repellent. However, fewer positive tests in a population could suggest that prevention strategies are working.

The Lyme Disease Ab with Reflex to Blot Test and Other Diagnostic Tools

13. How is the Lyme Disease Ab with Reflex to Blot test used in conjunction with a tick identification test? If a person finds a tick on their body and sends it for identification, and it is found to be a species that can carry Borrelia burgdorferi, then a Lyme Disease Ab with Reflex to Blot test may be ordered if the person develops symptoms of Lyme disease.

Can the Lyme Disease Ab with Reflex to Blot test be used along with a joint fluid analysis?

If a person has joint symptoms suggestive of Lyme arthritis, a Lyme Disease Ab with Reflex to Blot test may be used along with joint fluid analysis to help make a diagnosis.

How does the Lyme Disease Ab with Reflex to Blot test relate to a PCR test for Lyme disease? 

PCR tests for Lyme disease detect the genetic material of Borrelia burgdorferi, while the Lyme Disease Ab with Reflex to Blot test detects the body's immune response to the bacteria. PCR can sometimes provide a quicker diagnosis, but is less widely available and can be less sensitive than antibody testing.

Clinical Guidelines and Recommendations

What are the CDC recommendations regarding the use of the Lyme Disease Ab with Reflex to Blot test?

The CDC recommends a two-step process for testing blood samples that are being evaluated for evidence of antibodies against the Lyme disease bacteria. Both steps can be done using the same blood sample. The first step uses a testing procedure called EIA (enzyme immunoassay) or rarely, an IFA (indirect immunofluorescence assay). If this first step is negative, no further testing of the specimen is recommended. If the first step is positive or indeterminate (sometimes called "equivocal"), the second step should be performed. The second step uses a test called an immunoblot test, commonly, a "Western blot" test.

How do professional organizations guide the interpretation of the Lyme Disease Ab with Reflex to Blot test?

Professional organizations like the Infectious Diseases Society of America provide guidelines for the interpretation of Lyme disease testing results. These guidelines note that the test should be used as part of a clinical assessment, and that other factors such as symptoms and potential exposure to ticks should also be considered.

Can a Lyme Disease Ab with Reflex to Blot test be ordered for someone without symptoms if they had a known tick bite?

The general consensus in the medical community, as per guidelines from organizations like the CDC, is that testing should only be done if symptoms of Lyme disease are present, even in cases of known tick bites.

Can a Lyme Disease Ab with Reflex to Blot test be ordered for a patient with non-specific symptoms like fatigue or headache?

It can be, but it's not usually the first test ordered in these cases unless the patient's history suggests potential exposure to Lyme disease (e.g., frequent time spent in wooded areas, known tick bite).

How does the Lyme Disease Ab with Reflex to Blot test relate to the clinical diagnosis of Lyme disease?

Clinical diagnosis of Lyme disease is often made based on a combination of factors, including symptoms, potential exposure to ticks, and the results of a Lyme Disease Ab with Reflex to Blot test.

Can the Lyme Disease Ab with Reflex to Blot test be used in the management of Post-Treatment Lyme Disease Syndrome (PTLDS)?

The test may be used in the diagnostic process for PTLDS, but it is not used to manage the condition as the test does not measure treatment effectiveness.

Can the Lyme Disease Ab with Reflex to Blot test be used to evaluate the risk of developing Lyme arthritis?

This test can detect a past or current infection with Borrelia burgdorferi, the bacteria that can cause Lyme arthritis. However, it does not predict who will develop Lyme arthritis.

Can the Lyme Disease Ab with Reflex to Blot test be used in patients with skin manifestations like erythema migrans?

Yes, this test is often used in patients who present with skin manifestations like erythema migrans, which is a common early symptom of Lyme disease.

Can the Lyme Disease Ab with Reflex to Blot test help in diagnosing neurological Lyme disease?

Yes, in combination with other clinical findings and possibly other tests (like a lumbar puncture), the Lyme Disease Ab with Reflex to Blot test can help diagnose neurological Lyme disease.

Can the Lyme Disease Ab with Reflex to Blot test help diagnose Lyme carditis?

Yes, the Lyme Disease Ab with Reflex to Blot test can support the diagnosis of Lyme carditis by showing evidence of an immune response to Borrelia burgdorferi, the bacteria that cause Lyme disease. However, it is one piece of the puzzle, and diagnosis would also include clinical findings and possibly other tests.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

The following is a list of what is included in the item above. Click the test(s) below to view what biomarkers are measured along with an explanation of what the biomarker is measuring.

Also known as: Borrelia burgdorferi, Lyme Disease Ab with Reflex to Blot IgG IgM

Lyme Ab Screen

*Process times are an estimate and are not guaranteed. The lab may need additional time due to weather, holidays, confirmation/repeat testing, or equipment maintenance.

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