ARUP's Laboratory Test Directory

Borrelia burgdorferi Total Antibodies, IgG and/or IgM by ELISA with Reflex to IgG by Western Blot (Late Disease) : 0050268

Mnemonic: LYME CHRO

Ordering Recommendation: Preferred reflex test to detect Lyme disease in individuals with >4 weeks of clinical symptoms or exposure to tick. Positive/equivocal screen confirmed by Western blot.
Methodology: Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Qualitative Western Blot
Performed: Sun-Sat
Reported: 1-3 days
Specimen Required: Collect: Serum separator tube.

Specimen Preparation: Separate serum from cells ASAP or within 2 hours of collection. Transfer 2 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, or 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:
 
Test Number Components Reference Interval
0050216Borrelia burgdorferi Antibodies, Total by ELISA  
 
These reference intervals are to be used in the interpretation of Borrelia burgdorferi Total Antibodies, IgG and/or IgM by ELISA result
0.99 LIV or less Negative - Antibody to Borrelia burgdorferi not detected.
1.00-1.20 LIV Equivocal - Repeat testing in 10-14 days may be helpful.
1.21 LIV or greater Positive - Probable presence of antibody to Borrelia burgdorferi detected.
0050255Borrelia burgdorferi Antibody, IgG by Western Blot Effective August 15, 2011

Negative

Interpretive Data: Refer to report.
Note: This panel is appropriate for Lyme disease testing greater than four weeks from erythema migrans or onset of disease symptoms.

A negative result indicates that the Western blot evaluation for Borrelia burgdorferi 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 EIA test and confirm equivocal and positive with Western blot. Both IgM and IgG Western blots should be performed on specimens obtained less than four weeks after appearance of erythema migrans. Only IgG Western blot is to be performed on specimens 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. Please submit requests for appropriate Western blot testing within 10 days.

If ELISA result is 1.00 LIV, then IgG Western blot will be added. Additional charges apply.
CPT Code(s): 86618; if reflexed, add 86617
Cross References: Lyme Disease (Borrelia burgdorferi Total Antibodies, IgG and/or IgM by ELISA with Reflex to IgG by Western Blot (Late Disease)) , Lyme Disease Chronic Reflexive Panel (Borrelia burgdorferi Total Antibodies, IgG and/or IgM by ELISA with Reflex to IgG by Western Blot (Late Disease))