The Lyme Western Blot is a qualitative immunoassay in which antibodies specific to the B. burgdorferi antigens on a membrane strip are visualized. It is a qualitative test and is generally more sensitive and specific than the ELISA and IFA tests. In early or late stage of the disease when antibody levels are very low, western Blot can be positive whereas ELISA and IFA tests can be negative. This test must be used if the Lyme IgG/IgM antibody serology  or  Lyme IgG/IgA/IgM IFA is positive or equivocal. 

Principle

The Lyme Western Blot assay is based upon an antigen-antibody complex formation in the following steps:

  1. Binding of anti-Borrelia  specific antibodies in human serum to the western blot strip.  Western blot strip is a membrane strip with fixed B. burgdorferi antigens separated by size, on it.
  1. Binding of enzyme labeled anti-human IgG or IgM antibodies to the human anti– Borrelia antibodies bound to fixed B. burgdorferi antigens on the membrane. 
  1. Reaction with BCIP/NBT, a chromogenic substrate with bound antibodies on the strip.  A dark purple colored precipitate (band) develops on the antigen-antibody complexes. 

Lyme WESTERN BLOT IgM

The Lyme Western Blot IgM is a very sensitive indicator of exposure to B. burgdorferi.  It may be positive as early as 1 week after a tick bite. This test will usually remain positive for six to eight weeks after initial exposure and in some patients will remain positive for a very long time.  Re-exposure will also cause this test to be positive for a brief period of time.  For the testing to be complete, it is preferable that the IgM western blot be run along with the IgG western blot.


Lyme WESTERN BLOT IgG

The IgG Western Blot is an immunoassay and qualitative test in which antibodies are visualized.  The IgG antibody is typically present a few months following initial infection. 


Lyme WESTERN BLOT IgM

Reference Range

Negative <2 double started bands present on the blot


Lyme WESTERN BLOT IgG

Reference Range

Lyme WESTERN BLOT IgM

Clinical Significance

The Lyme Western Blot IgM is a sensitive indicator of exposure to B. burgdorferi. It may be positive as early as one week after a tick bite. This test will usually remain positive for six to eight weeks after initial exposure. Re-exposure will also cause this test to be positive for a brief period of time. In some patients this test can be positive for a very long time.  Lyme Western Blot IgM must be performed on any sample with positive or equivocal result for Lyme IgG/IgM antibody serology or Lyme IgG/IgA/IgM IFA.   For the testing to be complete, it is preferable that the IgM Western Blot be run along with the IgG Western Blot.


Lyme WESTERN BLOT IgG

Clinical Significance

The Lyme Western Blot IgG is a sensitive indicator of an exposure to B. burgdorferi.  IgG antibody is typically present a few months following the initial infection. Lyme Western Blot IgG must be performed on any sample with positive or equivocal result for Lyme IgG/IgM antibody serology or Lyme IgG/IgA/IgM IFA.

Lyme WESTERN BLOT IgM

Limitations

  1. Patients with other spirochetal disease and/or who test positive for rheumatoid factor or Epstein Barr virus may have cross-reacting antibodies and may have a positive result for 31, 41, and/or 83 kDa antigens
  2. Positive results for 31 and/or 34 kDa antigens may be present after Lyme vaccination in uninfected persons.
  3. A negative Western Blot does not exclude the possibility of infection with B. burgdorferi.
  4. IGeneX interpretation is based on internal validation studies.
  5. The results of this test must be interpreted in relation to patient’s clinical history, epidemiological data, stages of disease, clinical symptoms or other laboratory results.

Presence of any of the following bands: 23-25, 31, 34, 39 and  83-93 kDa as indeterminate or if only one of these bands is present in a negative report, it may have clinical significance. Therefore, we recommend testing with another method and/or retesting in 4-6 weeks.


Lyme WESTERN BLOT IgG

Limitations

  1. Patients with other spirochetal disease and/or who test positive for rheumatoid factor or Epstein Barr virus may have cross-reacting antibodies and may have a positive result for proteins 31, 41.
  2. Positive results for 31 and/or 34 kDa may be present after Lyme vaccination in uninfected persons.
  3. A negative Lyme Western Blot IgG does not exclude the possibility of infection with B. burgdorferi.
  4. IGeneX interpretation is based on internal validation studies.
  5. The results of this test must be interpreted in relation to patient’s clinical history, epidemiological data, stages of disease, clinical symptoms or other laboratory results.

Presence of an indeterminate number of double starred bands in a negative report may indicate clinical significance. Therefore, we recommend testing with another method and/or retesting in 4-6 weeks. 

Result Interpretation

Lyme WESTERN BLOT IgG

Ordering Information

  • Specimen Serum
  • Minimum volume 0.5 ml
  • Container SST (Serum Separator Tube) OR Leak-proof tube
  • Collection and Shipping Instructions See Serum and Whole Blood Samples- Collection & Shipping Instructions [THIS WILL LINK TO THAT PAGE]
  • Rejection Criteria Refer to general collection procedure

Lyme WESTERN BLOT IgG

Test Offered

Test# 188 Lyme Western Blot IgM CPT Code 86617
Test# 189 Lyme Western Blot IgG CPT Code 86617

Lyme Western Blot IgG & IgM are part of the following Test Panels:

Test Panel# 4090 Basic Lyme Panel**
Test Panel# 5010 Initial Lyme Panel
Test Panel# 6050 Complete Lyme Panel**
Test Panel# 6060 Basic Borreliosis Panel**
Test Panel# 6070 Complete Borreliosis Panel**
Test Panel# 8045 Complete Relapsing Fever Panel with Urine**
Test Panel# 8055 NN Special Borrelia Panel**
Test Panel# 5060 TBD Panel**
Test Panel# 6090 Super Borreliosis Panel**

**Test/Panels are not yet available for New York Residents