Borrelia burgdorferi Antibodies, IgG and IgM by Immunoblot (CSF)
Test Mnemonic
LYIBCS
CPT Codes
- 86617 - QTY (2)
Includes
- B. burgdorferi IgG Abs + Bands (18, 23, 28, 30, 39, 41, 45, 58, 66, 93 kDa)
- B. burgdorferi IgM Abs + Bands (23, 39, 41 kDa)
Performing Laboratory
ARUP
FDA Category
Laboratory Developed Test
Specimen Requirements
| Volume | Type | Container | Collect Temperature | Transport Temperature | Special Instructions |
|---|---|---|---|---|---|
| 3 mL | Cerebrospinal fluid (CSF) | Clean container | Refrigerated |
Minimum Specimen Requirements
| Volume | Type | Container | Collect Temperature | Transport Temperature | Special Instructions |
|---|---|---|---|---|---|
| 2 mL |
Stability
| Environmental Condition | Description |
|---|---|
| Refrigerated | 2 weeks |
| Frozen | 1 year (Avoid repeated freeze/thaw cycles) |
| Ambient | 8 hours |
Days Performed
Sun - Sat
Turnaround Time
2 - 5 days
Methodology
| Name | Description |
|---|---|
| Immunoblot (IB), Qualitative |
Special Info
Contaminated, heat-inactivated or hemolyzed specimens are unacceptable. If possible, specimens from New York clients will be sent out to a New York DOH approved laboratory
Clinical Info
Use in conjunction with positive serologic testing for the workup of suspected acute Lyme neuroborreliosis. Do not order when clinical symptoms are absent. IgG: 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. IgM: A positive result is reported when any 2 or more of the following bands are present: 23, 39, or 41 kDa. All other banding patterns are reported as negative. The detection of antibodies to B. burgdorferi in CSF may indicate central nervous system infection. However, consideration must be given to possible contamination by blood or transfer of serum antibodies across the blood-brain barrier. A negative result indicates that the immunoblot evaluation for B. burgdorferi antibody demonstrates no antibodies unique to B. burgdorferi and is therefore not supportive of Lyme disease. A positive result indicates that the immunoblot evaluation for Lyme antibody is consistent with the presence of antibody produced by patients in response to infection by B. 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. The current CDC recommendations for the serological diagnosis of Lyme disease are to screen with a polyvalent ELISA test and confirm equivocals and positives with immunoblot. Both IgM and IgG immunoblots should be performed on samples obtained less than 4 weeks after appearance of erythema migrans. Only IgG immunoblot is to be performed on samples greater than 4 weeks after disease onset. IgM immunoblot in the chronic stage is not recommended and does not aid in the diagnosis of chronic Lyme disease or neuroborreliosis.