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IGeneX, Inc. Reference Laboratory
Specializing in Lyme and Other Tick-borne Diseases
WHAT TEST(S) TO ORDER:

Based on our tracking, as well as input from our client physicians and our clinical consultant, the initial Panel to order for Lyme disease is the IGeneX Panel 6050. This panel includes the IFA, IgM and IgG Western Blots and PCRs for Borrelia burgdorferi. The IFA is a general Lyme disease screen.   The Western Blots are to determine which antibodies the patient is making. The Western Blot is 96% specific. Since some patients do not make antibodies, the Lyme Whole Blood PCR for DNA (#463) and the Lyme Serum PCR for DNA (#453) is included. 

The Complete Initial Lyme Panel includes IFA, IgG and IgM Western Blots and PCR (whole blood and serum):
   
Panel 6050*   #230 (Lyme IFA), #188, #189, #456, (and #453)
   
 

(IGeneX is now performing a courtesy PCR on serum if whole blood is ordered and vice versa if both serum and whole blood are received.)
   
The Initial Lyme Panel includes IgG and IgM Western Blots and PCR (whole blood and serum):
   
Panel 5010** #188, #189 & #456, (and #453)
   
 

(IGeneX is now performing a courtesy PCR on serum if whole blood is ordered and vice versa if both serum and whole blood are received.)

The follow-up test for Lyme disease, if the above is negative, is the Lyme Dot Blot/PCR Panel - #875.  This panel looks for pieces of the bacteria in urine as well as DNA of B. burgdorferi in the urine.  Most physicians use an antibiotic challenge to make the test more sensitive.  The antibiotic protocol, as well as the general instructions can be found in the urine testing kit available from the laboratory.  You may also call IGeneX for a copy of the protocol.

The combination of all of the above tests provides higher than 90% sensitivity and better than 95% specificity.  Remember that Lyme disease is a clinical diagnosis and testing can support your clinical presentation.

We also offer tests for the common co-infections of Babesia, Ehrlichia - Anaplasma phagocytophila (HGE) or  Human Monocytic Ehrlichia (HME), and Bartonella.  These co-infections are seen in approximately 20% of the patients with Lyme disease.  The usual first tests to order for the co-infections are IFA antibody tests: Babesia microti-#200, Ehrlichia: #203 Anaplasma phagocytophila (HGE) or #206 Human Monocytic Ehrlichia (HME), Bartonella- #285 and Babesia FISH-#640.    In Northern California, Oregon and Washington State, #710 (Babesia WA-1) is substituted for #200 for Babesia microti.   A complete Panel has been established for the Midwest, Southern and Eastern Region (Panel 5090), and a Panel for the Western Region (Panel 5080). The FISH test (#640) is also included since it is a more sensitive indicator of Babesia infection, even in the absence of antibodies.

Test kits are available with shipping materials at no charge from IGeneX, Inc. – Call 800/832-3200 or e-mail – customerservice@igenex.com

Nick S. Harris, Ph.D and Steven J. Harris, MD
October 2006

 *Not available for NY Residents
** Use for NY Residents