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Feb 21, 2017

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Lyme Ab, IgG with Reflex to Immunoblot

Lyme Ab, IgG with Reflex to Immunoblot (LYMIGGR) Chemistry Lab Test

Name: Lyme Ab, IgG with Reflex to Immunoblot

Test Name: Lyme Ab, IgG with Reflex to Immunoblot

Health Link Test Code: LYMIGGR

LIS Test Code: LYMIGGR

CPT Code(s): 86618

Methodology: Enzyme Immunoassay

Days Performed: Daily.

In-Lab Turnaround Time: 1 day.

Stat In-Lab Turnaround Time: Not available stat.

Specimen: Blood

Collection Container: Red cap with yellow ring (SST)

Also Acceptable: Red top

Collection Volume: 2 mL

Pediatric Collection Volume: 0.3 mL

Stability Ambient:

8 hours

Stability Refridgerated:

6 days

Stability Frozen:

6 months (only 2 freeze/thaw cycles)

Sample Analyzed: Serum

Testing Volume: 1 mL

Pediatric Testing Volume: 0.15 mL

Specimen Processing:

Centrifuge. If a complete barrier has not been formed, transfer cell-free serum to plastic vial and refrigerate.

Specimen Transport:

Transport specimen to UWHC Hospital Laboratory.  Transport with coolant pack if coming from clinic location.

Unacceptable Criteria:

Avoid hemolyzed, lipemic, and icteric samples.

Interpretation:

Negative IgG antibodies to Borrelia burgdorferi not detected.
Positive Presumptive detection of IgG antibodies to Borrelia burgdorferi.

Additional Information:

A negative result for Lyme IgG 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 IgG 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 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