My igm came back positive with bands 23 and 41. Igg was negative. Went to infectious disease doc and he said he thought it was a false positive and that he was gonna re-do the blood tests. When i called to get the results they said that the lyme antibody test for igg and igm was negative. Is that the same as a western blot? I dont think it is from what ive read. So i feel like he purposely tested me for the wrong thing knowing it would come back neg. Is the lyme antibody test the same as the ELISA TEST? And if so, you know how the CDC has said the two step approach is elisa, and if positive you do a western blot? How many people are actually tested that way and come back positive for the first test and then get a WB test? Or do most people just get a WB test first? I have an appt with an LLMD monday. If anyone could answer some of these questions. Thanks!!
Posted by Tonya27 (Member # 28369) on :
Oh yeah also the doctor believed it was a false positive because i have been feeling sick on and off for 18 months, so he said my igg would be positive by now. He said igm means new infection, and there is no way it is new cause i have been feeling ill for 18 months.
Posted by geo (Member # 18333) on :
Generally, the Elisa is performed first. This is a screening test. If it comes back equivocal or positive, the lab will then handle the western blot. At least this is how the big labs (labcorp and quest) handle it. The specialty labs like Stony Brook, MDL and Igenex are different.
Posted by bigstan (Member # 11699) on :
Hi Tonya, I'm in Mich, if you would like and LLMD referral to my doctor in Mich send me a PM.
It looks like you had a WB done because of the bands. And band 23 is a significant band for Lyme.
If possible did you get a copy of the results?
You can compare it to this WB breakdown:
Here is some info on the WB IgM and IgG antibodies.
IgM antibodies are the first antibodies to be produced in the body in response to an infection, and is produced in great quantity.
IgM antibodies are large, up to six times larger than the IgG antibodies. IgM antibodies, when present in high numbers, represent a new active infection or an existing infection that has become reactivated. Over time, the number of IgM antibodies will decline as the active infection is resolved.
IgG antibodies are produced once an infection has been going on for a while, and may be present after the infection has been resolved.
Generally speaking, the presence of IgG antibodies to an organism when accompanied by a negative IgM test for the same organism means that the person was exposed to that organism at one time and developed antibodies to it, but does not have a current active infection of that organism.
When it comes to Borrelia burgdorferi (Bb), the organism responsible for Lyme disease, that is not necessarily the case.
9 cross-reactive for Borrellia 12 specific for Bb 18 unknown 20 cross-reactive for Borrellia 21 unknown 22 specific for Bb, probably really the 23/25 band 23-25 outer surface protein C (OspC), specific for Bb 28 unknown 30 unknown; probably an outer surface protein; common in European and one California strain 31 outer surface protein A (OspA), specific for Bb 34 outer surface protein B (OspB); specific for Bb 35 specific for Bb 37 specific for Bb 38 cross-reactive for Bb 39 is a major protein of Bb flagellin; specific for Bb 41 flagellin protein of all spirochetes; this is usually the first to appear after a Bb infection and is specific for all Borrellia 45 cross-reactive for all Borellia (sometimes people with Lyme who have this band positive also have the co-infection Ehrlichiosis) 50 cross-reactive for all Borrellia 55 cross-reactive for all Borrellia 57 cross-reactive for all Borrellia 58 unknown but may be a heat-shock Bb protein 60 cross reactive for all Borrellia 66 cross-reactive for all Borrelia, common in all bacteria 83 specific antigen for the Lyme bacterium, probably a cytoplasmic membrane 93 unknown, probably the same protein in band 83, just migrates differently in some patients
The IgM tests for a more resent infection, the IgG a longer standing one. Band 41 is often the first to show and yours is positive. And you have a positive #23.
Posted by bigstan (Member # 11699) on :
Oh one more thing. The fact you have two positive bands is significant. A lot of times with Lyme a persons immune system shuts down and is so compromised that the ability to produce antibody's just isn't there.
Therefore they just don't show up on a WB. That is why Lyme is a clinical diagnosis. Find an LLMD.
Posted by bcb1200 (Member # 25745) on :
Elisa and WB both look for antibodies. But they do it in different ways.
Elisa uses a chem illumonescence technique where the antibody binds itself to a bead suspended in a liquid. Reagent is then added and if the antibody is present a flash of light is detected.
WB uses a gel and electricity and the sample gets stretched across / suspended in the gel dependinmg on its size. The location indicates the antibody.
2 diff techniques both looking for antibodies. Wb is more accurate.
Posted by Pinelady (Member # 18524) on :
There is no such thing as false positive...
Find a LLMD to help you...
Posted by Lymetoo (Member # 743) on :
[QUOTE]Originally posted by Tonya27:
My igm came back positive with bands 23 and 41. Igg was negative. Went to infectious disease doc and he said he thought it was a false positive and that he was gonna re-do the blood tests.
I don't believe in false positives...very rare..if they exist at all
When i called to get the results they said that the lyme antibody test for igg and igm was negative. Is that the same as a western blot?
I would say yes.
I dont think it is from what ive read. So i feel like he purposely tested me for the wrong thing knowing it would come back neg.
wouldn't be the first time an ID dr did that!
Is the lyme antibody test the same as the ELISA TEST?
no
And if so, you know how the CDC has said the two step approach is elisa, and if positive you do a western blot? How many people are actually tested that way and come back positive for the first test and then get a WB test?
Many come back with a negative ELISA. They are notorious for missing Lyme.
Or do most people just get a WB test first?
most LLMD's go straight to the WB first (see my comments above)
I have an appt with an LLMD monday. If anyone could answer some of these questions. Thanks!!
"With most infections, your immune system first forms IgM antibodies, then in about 2 to 4 weeks, you see IgG antibodies. In some infections, IgG antibodies may be detectable for years.
Because Borrelia burgdorferi is a chronic persistent infection that may last for decades, you would think patients with chronic symptoms would have positive IgG Western blots.
But actually, more IgM blots are positive in chronic borreliosis than IgG. Every time Borrelia burgdorferi reproduces itself, it may stimulate the immune system to form new IgM antibodies.
Some patients have both IgG and IgM blots positive. But if either the IgG or IgM blot is positive, overall it is a positive result.
Response to antibiotics is the same if either is positive, or both. Some antibodies against the borrelia are given more significance if they are IgG versus IgM, or vice versa.
Since this is a chronic persistent infection, this does not make a lot of sense to me. A newly formed Borrelia burgdorferi should have the same antigen parts as the previous bacteria that produced it.
But anyway, from my clinical experience, these borrelia associated bands usually predict a clinical change in symptoms with antibiotics, regardless of whether they are IgG or IgM." -- Dr C of MO