ARUP's Laboratory Test Directory

Borrelia burgdorferi Antibody, IgG by Western Blot : 0050255

Mnemonic: LYME G WB

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 Western blot test.
Methodology: Qualitative Western Blot
Performed: Sun-Sat
Reported: 1-2 days
Specimen Required: 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.

Stability (collection to initiation of testing): 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.
Note: This test should be used for confirmation of an equivocal or positive Borrelia burgdorferi Total Antibodies, IgG and/or IgM test performed on patients greater than four weeks after disease onset.  A negative result indicates that the Western blot evaluation for the Lyme 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 Borrelia burgdorferi 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
Cross References: Lyme Antibody (Borrelia burgdorferi Antibody, IgG by Western Blot) , Lyme Disease (Borrelia burgdorferi Antibody, IgG by Western Blot)