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» LymeNet Flash » Questions and Discussion » Medical Questions » I need help determining test results

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Author Topic: I need help determining test results
j_liz
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Hi All,

A friend of mine asked me to look at her daughter's Lyme tests, because she doesn't trust her pediatrician. I don't understand the tests, from what I read she is pos. for Lyme, but has been told she is neg.

Please help me. The results are from LabCorp.

One area of one test says: Lyme IgG/IgM 1.26 HIGH
IgM 23 present

The next test says: Lyme IgG/IgM 1.25 HIGH (is this and the above 1.26 titers?)

If you need more info to help let me know. Thanks!

Edited to say she was told "neg".

[ 05-19-2014, 11:30 AM: Message edited by: j_liz ]

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j_liz

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TF
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Did you mean to say that "she has been told she is NEGATIVE"?
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Lymetoo
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Yes, please explain....."from what I read she is pos. for Lyme, but has been told she is pos."
-

This looks like the ELISA:

Lyme IgG/IgM 1.26 HIGH

--

Band 23 is specific for Lyme .. Do you know if this was from a Western Blot?

--------------------
--Lymetutu--
Opinions, not medical advice!

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j_liz
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Yes, she was told neg. Sorry, Lyme brain.

The tests lists several tests. Listed is Western Blot and then further Lyme IgG/IgM.

--------------------
j_liz

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j_liz
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bump

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j_liz

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TF
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Is there any way you could post the actual test results--pictures of them for example.

With just this info, it is tough to make sense of it.

Especially post pictures of all of the pages of the Western Blot.

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j_liz
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Here's one:

CBC With Differential/Platelet; Rheumatoid Arthritis Factor; HLA B 27 Disease Association;
Antinuclear Antibodies Direct; Sedimentation Rate−Westergren; Lyme IgG/IgM Ab; Venipuncture
TESTS RESULT FLAG UNITS REFERENCE INTERVAL LAB
CBC With Differential/Platelet
WBC 6.2 x10E3/uL 3.4 − 10.8 01
RBC 4.53 x10E6/uL 3.77 − 5.28 01
Hemoglobin 13.0 g/dL 11.1 − 15.9 01
Hematocrit 38.3 % 34.0 − 46.6 01
MCV 85 fL 79 − 97 01
MCH 28.7 pg 26.6 − 33.0 01
MCHC 33.9 g/dL 31.5 − 35.7 01
RDW 13.6 % 12.3 − 15.4 01
Platelets 280 x10E3/uL 155 − 379 01
Neutrophils 50 % 40 − 74 01
Lymphs 39 % 14 − 46 01
Monocytes 7 % 4 − 12 01
Eos 4 % 0 − 5 01
Basos 0 % 0 − 2 01
Neutrophils (Absolute) 3.0 x10E3/uL 1.4 − 7.0 01
Lymphs (Absolute) 2.4 x10E3/uL 0.7 − 3.1 01
Monocytes(Absolute) 0.4 x10E3/uL 0.1 − 0.9 01
Eos (Absolute) 0.2 x10E3/uL 0.0 − 0.4 01
Baso (Absolute) 0.0 x10E3/uL 0.0 − 0.3 01
Immature Granulocytes 0 % 0 − 2 01
Immature Grans (Abs) 0.0 x10E3/uL 0.0 − 0.1 01
SPACE
Rheumatoid Arthritis Factor
RA Latex Turbid. 9.2 IU/mL 0.0 − 13.9 01
SPACE
HLA B 27 Disease Association
HLA−B27 Negative 02
HLA−B*27 Negative
HLA Lab CLIA ID Number 34D0954530
This test was performed using PCR (Polymerase Chain Reaction)/SSOP
(Sequence Specific Oligonucleotide Probes) technique. SBT (Sequence
Based Typing) and/or SSP (Sequence Specific Primers) may be used as
107−436−0997−0 Seq # 8778
©2004−14 Laboratory Corporation of America ® Holdings
All Rights Reserved
DOC1 Ver: 1.49
FINAL REPORT Page 1 of 2

04/24/14 16:03 ET
This document contains private and confidential health information protected by state and federal law.
If you have received this document in error, please call 800−631−5250
LabCorp Laboratory Corporation of America
Control Number
04/17/14 07:21 04/21/14 F 16/03/29 12/19/97
Date and Time Collected Date Reported Sex Age(Y/M/D) Date of Birth
LabCorp Raritan
69 First Avenue
Phone: 800−631−5250
Account Number
Specimen Number
Patient ID

Raritan, NJ 08869−1800
Patient Name
TESTS RESULT FLAG UNITS REFERENCE INTERVAL LAB
supplemental methods when necessary. Please contact HLA Customer
Service at 1−800−533−1037 if you have any questions.
Director of HLA Laboratory
Dr George C Maha, PhD
SPACE
Antinuclear Antibodies Direct
ANA Direct Negative Negative 01
SPACE
4 mm/hr 0 − 32 01
Sedimentation Rate−Westergren
SPACE
Lyme IgG/IgM Ab 1.25 High index 0.00 − 0.90 01
Negative <0.91
Equivocal 0.91 − 1.09
Positive >1.09
Note: The CDC currently advises that Western blot
testing be performed following all equivocal or
positive EIA results. Final diagnosis should include
appropriate clinical findings and a positive EIA
which is also positive by Western blot.

--------------------
j_liz

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j_liz
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Lyme, Western Blot, Serum; Sedimentation Rate−Westergren; Lyme IgG/IgM Ab; Venipuncture
General Comments
ACC: 57938903 PID:
TESTS RESULT FLAG UNITS REFERENCE INTERVAL LAB
Lyme, Western Blot, Serum
Lyme Ab IgG by WB: 01
IgG P93 Ab. Absent 01
IgG P66 Ab. Absent 01
IgG P58 Ab. Absent 01
IgG P45 Ab. Absent 01
IgG P41 Ab. Absent 01
IgG P39 Ab. Absent 01
IgG P30 Ab. Absent 01
IgG P28 Ab. Absent 01
IgG P23 Ab. Absent 01
IgG P18 Ab. Absent 01
Lyme IgG WB Interp. Negative 01
Positive: 5 of the following
Borrelia−specific bands:
18,23,28,30,39,41,45,58,
66, and 93.
Negative: No bands or banding
patterns which do not
meet positive criteria.
Lyme Ab IgM by WB: 01
IgM P41 Ab. Absent 01
IgM P39 Ab. Absent 01
IgM P23 Ab. Present Abnormal 01
Lyme IgM WB Interp. Negative 01
Note: An equivocal or positive EIA result followed by a negative
Western Blot result is considered NEGATIVE. An equivocal or positive
EIA result followed by a positive Western Blot is considered POSITIVE
by the CDC.
Positive: 2 of the following bands: 23,39 or 41
Negative: No bands or banding patterns which do not meet positive
criteria

Criteria for positivity are those recommended by CDC/ASTPHLD.
p23=Osp C, p41=flagellin
Note:
Sera from individuals with the following may cross react in the
Lyme Western Blot assays: other spirochetal diseases (periodontal
disease, leptospirosis, relapsing fever, yaws, and pinta);
connective autoimmune (Rheumatoid Arthritis and Systemic Lupus
Erythematosus and also individuals with Antinuclear Antibody);
other infections (Rocky Mountain Spotted Fever; Epstein−Barr Virus,
and Cytomegalovirus).
SPACE
3 mm/hr 0 − 32 01
Sedimentation Rate−Westergren
SPACE
Lyme IgG/IgM Ab 1.26 High index 0.00 − 0.90 01
Negative <0.91
Equivocal 0.91 − 1.09
Positive >1.09
Note: The CDC currently advises that Western blot
testing be performed following all equivocal or
positive EIA results. Final diagnosis should include
appropriate clinical findings and a positive EIA
which is also positive by Western blot.

--------------------
j_liz

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j_liz
LymeNet Contributor
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I hope that's not too confusing. I don't know how to post pics of it and not get the personal info. So, I copied/pasted.

--------------------
j_liz

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TF
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OK, so the patient had an ELISA (EIA) test which was positive through LabCorp.

So, then LabCorp is required to do a Western Blot which was only positive on IgM band 23.

According to mainstream medicine, this is a negative Western Blot. Case closed.

However, a lyme doctor would not be satisfied with this at all. Since the patient got a positive ELISA and a positive on a very important band on the Western Blot, a lyme doctor would try a course of lyme treatment.

Or, if the parent was unwilling, a lyme doctor would test again through Igenex which records more of the lyme bands. The patient could then get a positive Western Blot.

Also, a lyme doctor would test the patient for coinfections. If the child has any coinfections, that is additional proof of lyme disease. (These infections are found together, not alone.)

If this were my child, I would want a course of lyme treatment to see how the patient reacts. The positive ELISA and band 23 on the WB are "the smoking gun."

The child had exposure to lyme bacteria. Otherwise, they would not have gotten these results.

It is typical that the patient does not have enough positives from a LabCorp lyme test for a non-lyme specialist to diagnose lyme. But, if the patient has symptoms of lyme and the band 23 positive, a lyme doctor would treat for lyme.

You can read this in Dr. C's explanation of the Western Blot found here:

http://flash.lymenet.org/ubb/ultimatebb.php/topic/1/42077

See this quote:

"In my clinical experience, if a patient has symptoms suspicious for borreliosis, and has one or more of the following bands, there is a very high probability the patient has borreliosis.

These bands are 18, 22, 23-25, 28, 30, 31, 34, 37, 39, 41, 83, and 93."

See this quote from page 7 of Burrascano, regarding how to diagnose lyme disease:

"DIAGNOSTIC HINTS

Lyme Borreliosis (LB) is diagnosed clinically, as no currently available test, no matter the source or type, is definitive in ruling in or ruling out infection with these pathogens, or whether these infections are responsible for the patient's symptoms. The entire clinical picture must be taken into account, ... .

Consideration should be given to tick exposure, rashes (even atypical ones), evolution of typical symptoms in a previously asymptomatic individual, and results of tests for tick-borne pathogens. Another very important factor is response to treatment- presence or absence of Jarisch Herxheimer-like reactions, the classic four-week cycle of waxing and waning of symptoms, and improvement with therapy." (Page 7)

See the very important last sentence. To make the diagnosis, you give the patient some treatment and observe their response.

I hope the parent is willing to do so. Otherwise, I do not expect this child to get better but rather worse.

God bless you for your concern and help for this child.

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Sammi
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This person has a positive ELISA and band 23 on the Western Blot. Band 23 is a Lyme-specific band. Realize that labs such as Quest and LabCorp do not list all the Lyme-specific bands (31 and 34) that Igenex does.

These results are significant. This person should see a Lyme doctor and be evaluated for co-infections.

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j_liz
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Thank you! I will pass on this info.

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j_liz

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Nick Dokken
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Hello,

I just had some blood work done as I've had chronic back pain for 5 years. Very sporadic, very painful (at times). Tried yoga, massages, chiropractor, nothing has worked. So I went to the doctor, had some imaging done which revealed some pars defects, spondylothesis (sp.), and some other minor things. My blood work on the other hand came back with the following:

IgG P41 Ab - PRESENT
IgG P39 Ab - PRESENT
IgM P23 Ab - PRESENT

Then it says, "3 antibodies present, high risk for possible lyme exposure. recommend follow up"

When I called to schedule follow-up, the nurse said it was nothing urgent and I can't be seen for a week. Is this something I should be worried about? Anyone have insight here with these antibodies?

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Nick Dokken

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