Name: Lyme Ab, IgM with Reflex to Immunoblot
Test Name: Lyme Ab, IgM with Reflex to Immunoblot
Health Link Test Code: LYMIGMR
LIS Test Code: LYMIGMR
CPT Code(s): 86618
Methodology: Enzyme Immunoassay
Days Performed: Daily.
In-Lab Turnaround Time: 1 day.
Collection Container: Red cap with yellow ring (SST)
Also Acceptable: Red top
Collection Volume: 2 mL
Pediatric Collection Volume: 0.3 mL
6 months (only 2 freeze/thaw cycles)
Sample Analyzed: Serum
Testing Volume: 1 mL
Pediatric Testing Volume: 0.15 mL
Centrifuge. If a complete barrier has not formed, transfer cell-free serum to plastic vial and refrigerate.
Transport specimen to the UWHC Hospital Laboratory. Transport with coolant pack if coming from clinic loaction.
Avoid hemolysis, icteric, and lipemic samples.
|Negative||IgM antibodies to Borrelia burgdorferi not detected.|
|Equivocal||Imprecise detection of Borrelia Burgdorferi. Repeat testing in 10-14 days may be helpful.|
|Positive||Presumptive detection of IgM antibodies to Borrelia Burgdorferi.|
A negative result for Lyme IgM antibodies does not rule out the possibility of B. burgdorferi infection. Patients in early stages of infection or those receiving antimicrobial therapy may not produce detectable levels of antibody. Patients with clinical history and/or symptoms suggestive of Lyme disease, but with negative test results, should be retested in 4-6 weeks if clinically indicated. There currently is no test of cure for Lyme disease, and this test should not be ordered for that purpose.
Positive results in the Lyme IgM screening assay must be interpreted with caution. Cross-reactivity has been shown in patients with Hepatitis A, HIV, HSV, Helicobacter pylori, Leptospirosis, Rickettsiosis, Syphilis, Systemic Lupus Erythematosus, Antinuclear Antibodies, and Toxoplasmosis. The effect of Babesiosis, Erhlichiosis, and Rocky Mountain Spotted Fever on this assay is not known.
Positive or equivocal screening results will be confirmed by immunoblot. After 4 weeks of symptoms, the specificity of the IgM immunoblot is reduced and it does not aid in the diagnosis of infection. In those instances only the IgG immunoblot should be ordered. There currently is no test of cure for Lyme disease, and this test should not be ordered for that purpose.