Sorted By Test Name - Mayo Medical Laboratories

CLYWB
83857
FBBC6
91899
after onset. Normal specimens and false-positive EIA specimens generally have antibodies to 4 or fewer
proteins. Except for early patients, antibodies from patients with Lyme disease generally bind to 5 or more
proteins. For persons who have received recombinant OspA vaccine and who are not infected with
Borrelia burgdorferi, an intense band representing antibody to the OspA protein (band 30) should be
visible on the Western blot.
Reference Values:
IgG: negative
IgM: negative
Clinical References: 1. Dressler F, Whalen JA, Reinhardt BN, Steere AC: Western blotting in the
serodiagnosis of Lyme disease. J Infect Dis 1993;167(2):392-400 2. Brown SL, Hansen SL, Langone JJ:
Role of serology in the diagnosis of Lyme disease. JAMA 1999;282:62-66 3. Anonymous: Lyme
disease-United States, 1995. MMWR Morb Mortal Wkly Rep 1996;June 14;45(23):481-484
Lyme Disease Antibody, Western Blot, Spinal Fluid
Clinical Information: Lyme disease is caused by the spirochete Borrelia burgdorferi. The spirochete
is transmitted to humans through the bite of Ixodes species ticks. Endemic areas for Lyme disease in the
United States (U.S.) correspond with the distribution of 2 tick species, Ixodes dammini (Northeastern and
Upper Midwestern U.S.) and Ixodes pacificus (West Coast U.S.). In Europe, Ixodes ricinus transmits the
spirochete. Lyme disease exhibits a variety of symptoms that may be confused with immune and
inflammatory disorders. Any of the following clinical manifestations may be present in patients with
Lyme disease: skin lesions or cardiac or neurological disease. In the first stage of disease, inflammation
around the tick bite causes skin lesions, erythema chronicum migrans (ECM)--a unique expanding skin
lesion with central clearing that results in a ring-like appearance. Culture of skin biopsies obtained near
the margins of ECM are frequently positive. Neurologic and cardiac symptoms may appear with stage 2
and arthritic symptoms with stage 3 of Lyme disease. In some cases, a definitive distinction between
stages is not always seen. Further, secondary symptoms may occur even though the patient does not recall
a tick bite or rash. The presence of antibodies to Borrelia burgdorferi in cerebrospinal fluid (CSF) is
suggestive of neurologic Lyme disease (Lyme neuroborreliosis). PCR testing also may be used to confirm
late-stage neurologic disease. However, the sensitivity of PCR is low when testing CSF. Early antibiotic
treatment of Lyme disease with an appropriate antimicrobial regimen can resolve clinical symptoms and
prevent progression of the disease to later stages. The antibody response may be suppressed in patients
receiving appropriate antibiotic therapy early during the disease.
Useful For: Supplementing positive Lyme disease antibody screen (EIA) results and serving as an aid
in the serologic diagnosis of Lyme neuroborreliosis
Interpretation: Currently no criteria exist for the interpretation of Western blot testing on
cerebrospinal fluid. The presence of any bands may represent either intrathecal antibody production or
passive transfer of antibody from blood.
Reference Values:
IgG: none detected
IgM: none detected
Clinical References: Steere AC: Borrelia burgdorferi (Lyme disease, Lyme borreliosis). In
Principles and Practice of Infectious Diseases. 5th edition. Edited by GL Mandell, JE Bennett, R Dolin.
Philadelphia, Churchill Livingstone, 2000, pp 2504-2518
Lyme Disease C6 Antibody, Total
Reference Values:
REFERENCE RANGE: < or = 0.90
INTERPRETIVE CRITERIA:
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