david1097
Frequent Contributor (1K+ posts)
Member # 3662
posted
Here is something interesting....
Totally symptomless patient tested for screening purposes only.... with large number of Lyme specific Igg and Igm bands. I have looked around for Lyme WB reliabilty statistics and have found nothing.
Anybody seen or come across any publications on cross reactivity or contamination statistics (ie false positive?)
Posts: 1184 | From north america | Registered: Feb 2003
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posted
When I was deciding where to get tested I came across some information about active Epstein-Barr possibly causing a false positive on the Western Blot.
I did have an active infection with high viral capsid antibodies so I chose to use Bowen instead. When the antibodies calm down I'll go with Igenex and the Western Blot.
posted
There's a lot of information on cross-reactivity if you research Lyme vs lupus. Sorry I'm not very techie, or I'd give links. I use Yahoo and just type in Lyme lupus...Igenex also has information on this in their informational materials.
I have never been able to tell from reading, if this cross-reactivity is mainly just the Elisa. I called Nick Harris, director of Igenex,and he confirmed that there was some cross-reactivity with autoimmune illness on the Western Blot, but he listed bands that he thought were NOT affected, and as I remember it was all the Lyme specific bands, 23-25, and 39 were included.
I have not been able to get any MD's in researching this for me. it seems essential clinically when you have positive ANA's (or even anti-DNA's, and skin biopsies like we do) as well as positive Western Blots.
The research I did showed that Lyme can affect autoimmune labs such as these, and autoimmune illness can affect Lyme labs too. A totally circular situation. It's impossible to tell...
A positive syphilis test is actually one of the criteria for a diagnosis of lupus, and we all know syphilis is another spirochete. But MD's don't theorize that lupus patients actually have syphilis.
The LLMD's will say that the Lyme has triggered autoimmune activity, so, in a sense, both tests are correct. They don't consider the positive ANA's "false," But rheumatologists are more likely to either ignore or explain away the positive Western Blots as "false positives."
Clinically, for us, this issue has been relevant to the decision about whether to treat with abx (yes, and some treat auotimmune illnesses like lupus this way anyway) whether to avoid steroids (yes, and actually the rheum. never has suggested these), and Plaqueil is a good drug for both possibilities.
David, this may not be the reason you asked, but autoimmunity is the main source of cross-reactivity, according to Igenex. In the back of my mind, even with positive Western Blots, I don't feel 100% certain of Lyme diagnosis, although I feel more sure of that than anything else.
I haven't seen any speculation in the rheum. literature about WHY lupus patients may test falsely for syphilis. Interesting question.
posted
Just remembered that you said "symptomless" patients. One of my kids is symptomless and has VERY positive Western Blot (IgM) and positive ANA. My son has Lyme specific bands but not symptoms, althogu he had some symptoms 8 years ago.
So some of the people screened might haveimmune systems that are holding the infection off, and/or the Lyme could be dormant. The definition of symptomless is also open to question. Once I got the positive results for my daughter, we did realize she ahs SOME symptoms, but not really enough to have testing done in a family that wasn't already dealing with Lyme.
Maybe this just shows that entire segments of the population have been bitten by Lyme-carrying ticks, and may never get sick unless their immune systems are impaired, or turn against them.
posted
I totally agree with lyddie, I have probably had lyme for years and years, lived in the country in Virginia for 26 years and was bitten by ticks on and off.
Small symptoms would show up, but nothing that worried me. Lyme dug its heels in when I started commuting four hours a day and had a very stressful job; even then it took about 18 months before the lyme really kicked in as my immune system fell apart from sheer stress and exhaustion.
My holistic doc and my chiropractor both have lyme and babs, both are as healthy as horses, in other words no symptoms at all.
I believe lyme is everywhere waiting for the body to give the signal. It is a lesson to all about taking care of your health and never giving it up to a corporation or anything else!
Lymelady
Posts: 484 | From Fredericksburg, Va USA | Registered: Sep 2004
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Lyddie
Unregistered
posted
I'm practically instant-messaging here, because today I am especially concerned about this issue. Like yourself, I agreed to treat my 12 year-old (also a dancer, I wonder if dancing helps keep the infection down-?). She tested very positive on the IgM Western Blot, a few little symptoms here and there, but nothing I would have given that much thought to (w/out Lyme in the family).
Today, she is coming off the abx. She has absolutely no "herxes" and has had absolutely nothing that could even possibly be a symptom for 2 months.
Lyme patients should try coming off abx if they are symptom-free on abx for two months, but it is hard to tell this if the child was virtually symptom-free to start with!
It is hard to have them on medications based on testing alone...I worry about side effects.
It is strange that so many families have this pattern, with multiple family members testing positive, some sick, some not, and in many cases like ours, the sickest family member doesn't even test fully positive! Is there some sort of exposure going on that doesn't cause actual illness or infection?
Because puberty caused problems for my other child, I did decide to treat my youngest (the dancer). In the past, When she came off abx, she again had a problem with a sensation of having something in her eye. This is really her only symptom. Her asthma can get a little worse maybe (caused by a virus when she was one and a half), but this is questionable. That's about it.
I am hoping that her eye problem does not return and she can stay off.
it is very hard to decide what to do. I am hoping that by treating children who aren't sick, we can prevent the infection from ever causing the problems, esp. during the heart of puberty. But who knows! Noone does. There isn't enough knowledge or research yet, and our LLMD's are guessing in some ways. Educated guesses, but guesses.
My daughter did 6 weeks of strong dose of amoxicillin last Jue, then zithromax and Plaquenil, but I honestly gave her half the dose I take because she only weighed 65lbs. She came off twice, and both times the eye thing came back. Our LLMD put her on a heavy dose of tetracycline in December, and now says she can come off. In the last 7 months, she's been on abx for maybe 5 1/2 months with two breaks, adn the longest strectch of time being almost 3 months.
In the meantime, tell her to keep on dancing!
[This message has been edited by Lyddie (edited 01 February 2005).]
david1097
Frequent Contributor (1K+ posts)
Member # 3662
posted
This whole thing of symptomless positives is interesting. Guys like Steere have calimed for a long time that Igenex is too liberal in assigning WB bands, is he right?
I will probably get stomped for this post but there are a LOT of people on this board who put very HEAVY reliance on the WB results. Not so in the ILADS guidelines... there is a scoring criteria in which positive WB alone accounts for a low score (3 or 4 out of 10 I believe).
This question is not only important to familes with a Lyme disease sufferer but it is also VERY important to everyone since the credibility of the lyme community can be called into question with blind reliance on tests that give false positives.
Have blind studies been carried out to see how many people have positive Lyme specific WB bands and no disease?
Is this why the CDC picked the bands that it did?
Is this why the Elisa first?
The WB bands represent antibodies to fragments of the bacteria, can exposure to blebs cause the antibodies to be produced as blebs are basically encapsulated fragements of the out surface. Similarly can exposure to a person who is shedding fragments as a result of treatment somehow cause an antibody response to to the fragments.
The WB tests may in fact be virtually useless to confirm Lyme one way or the other, maybe not even sufficient to suggest it???.
As I noted, this is very important question and is for the most part at the heart of the "duck" bashing issue. These so-called "ducks" might be right, at least some of the time.....
Posts: 1184 | From north america | Registered: Feb 2003
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posted
I've wondered if a lot of people who think they have Lyme really have systemic Candida. Then they make it worse with prolonged abx. Then I've always wondered if a bad yeast infection could produce a false positive. I obviously have nothing to support this. It's just something I've wondered. Again I don't know the science behind it but there are false positive in all kind of other tests, AIDS and what not. I don't know, it's a controversial question on this site, but I think it's an important one.
Posts: 635 | From Texas | Registered: Mar 2004
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treepatrol
Honored Contributor (10K+ posts)
Member # 4117
posted
Food for thought?
""If the CDC is correct and Dearborn is relevant, then the vaccine may be triggering an immune response to Borrelia burgdorferi in people we never recognized as infected with the spirochete, although they were. It could mean there is a lot more Lyme out there than we ever realized," says Harris of IgeneX. "But, if Imugen is right, we need to go back to the drawing board and determine a new definition for the disease."
[This message has been edited by treepatrol (edited 01 February 2005).]
Posts: 10564 | From PA Where the Creeks are Red | Registered: Jun 2003
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Lyddie
Unregistered
posted
David I would be interested in your source, where you read anything critical of Igenex, the possibility of too many positives from Igenex, etc. Is Igenex a recognized or certified or whatever lab?
As my fmaily proceeds into our 4 th year of "all this Lyme stuff" (I know I have Lyme and have extensive neuro symptoms as evident in my pitiful efforts to type properly).. .I continue to feel the best approach is to always be open to all sides of every question. Skepticism is alwasy good, if painful. All we can do is to listen to all opinions and make the best judgement call for this day or this week or this month.
More studies are needed! Thanks for raising this question...
treepatrol
Honored Contributor (10K+ posts)
Member # 4117
posted
History IGeneX, Inc. is a specialty immunology laboratory and research facility, providing personalized service to over 1,000 private practice physicians, hospitals, and other clinical reference laboratories throughout the U.S. and Canada. The laboratory also functions as a pilot site for diagnostic manufacturers in the introduction of new assays, and has extensive collaborative agreements with multiple research groups.
The Reference Laboratory, founded in 1983, was purchased from 3M Diagnostic Systems (3MDS-Santa Clara, CA and BioWhittaker, Inc., Walkersville, MD) in 1991 by IGeneX, Inc. and moved to Palo Alto, California.
The laboratory is CLIA-certified, inspected by the Department of Health and Human Services for Medicare testing, and is also licensed in those states with special requirements (California, Florida, Maryland, New York, and Pennsylvania).
Personnel include MDs, PhDs, and California licensed and nationally certified clinical laboratory scientists (medical technologists); research, accounting, and marketing staffs; and client service specialists. Directing the staff are Jyotsna S. Shah, PhD, CCLD, MBA and Boyd G. Stephens, MD; Clinical Consultant: Steven J. Harris, MD; and Nick S. Harris, PhD, AMBLI, President.
A letter from the President: Our staff of professionals, who have worked together for many years, is committed to the following practices, ideals, and procedures:
State-of-the-art testing methodology; Rapid turn-around-time -- in most cases 48 hours; Dedication to personalized testing; Willingness and availability to answer your diagnostic questions; Ongoing refinement of existing tests; and, Research and development for innovative quality tests to enhance your diagnostic tools. Nick S. Harris, Ph.D., ABMLI President, IGeneX, Inc.
Laboratory Certifications CLIA 05D0643914 Medicare ZZZ32759Z CA State Dept of Health CLF4033 FL State Dept of Health 800002892 MD State Dept of Health 885 NY State Dept of Health 3172-805133A0 PA State Dept of Health 025659
Credits The PCR is performed under a license from Roche Molecular Systems.
Procedures may change depending upon the availability of reagents from other manufacturers. IGeneX will notify customers when alternate methods are used.
There one of thee best!
Nick S. Harris, Ph.D., ABMLI
Doctor Harris is a Diplomate of the American Board of Medical Laboratory Immunology. He received his Ph.D. in immunology at the University of Illinois, at the medical center, in Chicago. Upon completion of his fellowship in Transplantation Surgery at the University of Minnesota, he went to the University of Texas Medical Branch where he was the Director of Transplantation/Immunology at the Shriners Burns Institute and Associate Professor of Surgery and Genetics. In 1977 he was director of immunology at BioScience Laboratories (now SmithKline) in Van Nuys, California. In 1983 he was the technical and clinical studies director of 3M Diagnostics Systems (3MDS). In 1991 he founded IGeneX, Inc. Reference Laboratory. Dr. Harris has lectured extensively and published in the area of Lyme disease diagnosis. He was a committee member for Lyme disease of the NCCLS (National Council of Clinical Laboratory Standards) and on the advisory board of the Lyme Alliance, the Lyme Disease Community Coalition and the Lyme Disease Association of New Jersey. He is on the Board of Directors of the International Lyme and Associated Disease Society (ILADS) and the California Lyme Disease Association (CALDA).
Posts: 10564 | From PA Where the Creeks are Red | Registered: Jun 2003
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posted
I wouldn't consider a SYMPTOMLESS positive to be a FALSE positive. The test detects evidence that the bacteria is present, not sickness from the bacteria.
If take a group of 'healthy' people and examine their blood and tissues very thoroughly you would find all sorts of unexpected disease causing organisms. That's why we were given immune systems.
If you have a positive WB and don't feel sick do you have it? Probably, IMO. You would be surprised at the other things you have in you if you only knew. You immune system is just doing its job well, and may continue to do so if you take good care of your body. It is keeping the problem under control without your even having to know about it.
The WB is still valuable information. It alerts you to take supportive measures to give your body all the help it can get, and not do things that abuse and weaken it.
It also alerts you to be watchful for symptome if it becomes more than your immune system can handle.
My money would be on the Borrelia being in that person if the test was positive,,, it just isn't causing disease at the moment.
Posts: 714 | From San Antonio TX | Registered: Oct 2004
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Although I did have symptoms after my tick bite, it was a good two years before the roof fell in. And I got no treatment during that time. Don't know why it suddenly got worse. Those people who are symptomless may stay that way or become sick at some future time. Should they get treated or not, when they aren't having any symptoms? I haven't the foggiest notion. Maybe their immune system will hold it down, maybe it won't.
But, lots of people have been exposed/carry around H. pylori. How many of those actually develop ulcers or get stomach cancer as a result? And why do some people have these problems, while others do not?
Posts: 8430 | From Not available | Registered: Oct 2000
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MammaLyme
Frequent Contributor (1K+ posts)
Member # 1257
posted
I was around when the other side took bands from the WB along with the CDC to tout their lymerex vaccine. I was around when we marched on Washington to have this vaccine taken off the market because it made healthy people so ill and caused a lyme-like illness. Get the WB from Igenex and get the Bowen test to show you all the coinfections in your blood plus the amount of lyme you are dealing with. www.bowen.org They have their patent and now are waiting for FDA approval. Go to www.lymediseaseinformation.com and print out the Pfizer pamphlet showing the coinfections that Bowen finds in your blood. This is the best test around. Do not fool with any of the other tests. I have been there and done that. I went to 16 different doctors who thought I had Lupus, or MS because I had the white spots on the MRI, very high ANA count, anticardio lipid antibody (see site about autoimmune diseases from lyme)http://www.neuroland.com/cvd/aps I went 16 different doctors from the time I was bitten in 1994 until 2000 when the LUAT test came out. I tested two out of three positive for lyme. I had creepy things going around my face, numbness coming and going around my face and on the right side of my chin and tongue; fevers; heart issues; {skipping and racing} very high blood pressure that went to a regular of 120/70 to 220/110. This disease mimics so many others. Do not let anyone tell you it is not lyme. Get tested by Bowen so you know the truth. I had not only the lyme but HME, HGE and babesia when I got my test results back from Bowen. That was in the year 2001. I have tested with them only. I am now free of the coinfections. The other labs showed: Quest-band 41; BBI -babs; PCR from Igenex - lyme; MDL showed nothing (they were worthless); and I tested positive on the lyme test from Quest. Finally, when I went to a presentation in PA that the doctor told us about Bowen, I asked my family doctor to get me the test. I was saved by this test. If you do not know you have coinfections, you cannot get well. Take my advise, been around for all of the nastiness and hopefully, the Bowen test becomes the first test for everyone. Take care all.
Posts: 2173 | From Maryland | Registered: Jun 2001
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lymiecanuck
Unregistered
posted
I often ask myself these questions too. I usually end up thinking that immune system and infection load are the cause of getting sick from this. Stress being the number one threat to the immune system with diet and lifestyle a close second.
I have had lyme a long time, but the neruo pain didn't come until after my son and lots of stress in my life etc.
posted
Again, I ask the question, when should you say enough is enough for a symptom free child who has really never had lyme symptoms but tested postive. She has been on 2000mg ceftin and 200 mg of doxy and mepron for 7 months now.
please any thoughts on that.
I am having second guesses about LLMD with treatment of her. I just him with treatment of hubby because I can see finally his inprovement, but I do not want my daughter to stay on all this med.
Posts: 191 | From Eastern Shore. Maryland USA | Registered: Jun 2003
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Lyddie
Unregistered
posted
Our LLMD has taken my daughter off after 6 months (w/2brief breaks). If you daughter isn't herxing and isn't having symptoms, on the meds, this particular doctor would think that would be enough.
I plan on being very watchful for any symptoms once my daughter is off. Parents like us should keep each other posted on this issue.
david1097
Frequent Contributor (1K+ posts)
Member # 3662
posted
I'm not trying to knock Igenex. I am just repeating what others have said about "those labs" than "give false positives". This is a very common statement by many Dr's that don;t treat lyme every day. If in fact the WB tests can give "false" positives, this should be well advertised so that additional weight can be placed alternate diagnosis metrics. This is very important asn it has a lot to do with people not getting proper treatment. Basically Lyme has a very bad name in the medical community and this is one way to correct the problem.
Here are some real important questions, particularly for children.
How many symptomless positives are there?
If the bug is persistent, does treatment with no symptoms do anything?
Does it make the bug more resistant?
Does it make the bug dig in deeper?
Needless to say, up until this point I had thought that lyme specific bands would result in SOME symptoms. This may not be the case and if so how many are in this same boat.
I know that infections can simmer at an asymtpmatic level for many many years and then pop up. But in the case of Lyme, if a lot of people have it then the whole question of disease vector has to be re-thought. Bowen has illuded to this but the method of testing they use is basically non standard and controls are therefore difficult to establish based on published data.
????????
Posts: 1184 | From north america | Registered: Feb 2003
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treepatrol
Honored Contributor (10K+ posts)
Member # 4117
posted
quote:Originally posted by david1097: I'm not trying to knock Igenex. I am just repeating what others have said about "those labs" than "give false positives". This is a very common statement by many Dr's that don;t treat lyme every day. If in fact the WB tests can give "false" positives, this should be well advertised so that additional weight can be placed alternate diagnosis metrics. This is very important asn it has a lot to do with people not getting proper treatment. Basically Lyme has a very bad name in the medical community and this is one way to correct the problem.
Here are some real important questions, particularly for children.
How many symptomless positives are there?
If the bug is persistent, does treatment with no symptoms do anything?
Does it make the bug more resistant?
Does it make the bug dig in deeper?
Needless to say, up until this point I had thought that lyme specific bands would result in SOME symptoms. This may not be the case and if so how many are in this same boat.
I know that infections can simmer at an asymtpmatic level for many many years and then pop up. But in the case of Lyme, if a lot of people have it then the whole question of disease vector has to be re-thought. Bowen has illuded to this but the method of testing they use is basically non standard and controls are therefore difficult to establish based on published data.
????????
I dont think anyone did say you were knocking Igenex.
I was responding to Lyddie
I just responded David I would be interested in your source, where you read anything critical of Igenex, the possibility of too many positives from Igenex, etc. ((((Is Igenex a recognized or certified or whatever lab?)))))
[This message has been edited by treepatrol (edited 01 February 2005).]
Posts: 10564 | From PA Where the Creeks are Red | Registered: Jun 2003
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david1097
Frequent Contributor (1K+ posts)
Member # 3662
posted
This waqs a quote that someone repeated from Dr. A Steere. The comment was apprently made to Dr's not particularly familiar with Lyme treatment at a medical conference on a session dealing with Lyme. I can try to dig it up but it was in the fall in the North east somewhere.
Posts: 1184 | From north america | Registered: Feb 2003
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Linda LD
Frequent Contributor (1K+ posts)
Member # 6663
posted
I just wished I had been treated as a kid, rather than finding out AFTER I gave Lyme to both my children. I never even had an antibiotic until I was in 20's and use to tell people I was 'allergic" to antibiotics because they made me fill so bad.
My opinion (and I'm not a doctor): Give the child antibiotics until they no longer herx. Then watch, carefully.
Posts: 1171 | From Knoxville, TN US | Registered: Dec 2004
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posted
There was an important article published in Nature (July, 2004) titled "Frontal and stealth attack strategies in microbial pathogenesis." It should have been heralded by a trumpet fanfare.
It says that we know more about frontal assault strategies of microbes but not much about stealth attacks. There is a chart describing characteristics of these two strategies, including (in the stealth column) incubation period may be indeterminate, indolent or asymptomatic carriage, engages the innate immune system, avoids or manipulates the adaptive immune system, etc.
Then the article goes on to describe several microbes that use stealth tactics to establish chronic infections. Bartonella is one of them. Borrelia was not included but fits the profile very well.
It also describes situations where some of the 500 or so bacterial species that inhabit us can switch from commensal to pathogenic.
What they are pointing out in this review article is that the stealth pathogens need more study. Meaning that some of the questions we are asking do not have answers at this point. And chronic diseases need more research. Which we certainly know!
A quote from the end of the article: "Gaining a thorough knowledge of chronically infecting microbes and learning how to control them is perhaps the greatest challenge."
(If I keep on editing this message forever, maybe everything will get spelled correctly. Can't spell anymore.)
[This message has been edited by lou (edited 02 February 2005).]
[This message has been edited by lou (edited 02 February 2005).]
[This message has been edited by lou (edited 02 February 2005).]
Posts: 8430 | From Not available | Registered: Oct 2000
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treepatrol
Honored Contributor (10K+ posts)
Member # 4117
quote:Originally posted by Linda LD: I have had lyme disease since I was a child.
Yes, you can have lyme and look great, be active, feel great. It is only when your body gets really run down that you are going to realize something is really going wrong with your body.
I agree! I've had Lyme since I was around 8 yrs old. I was frequently ill, had major problems off and on over the next 42 yrs. Was dxd with numerous other maladies.
Was dxd with Lyme 4 1/2 yrs ago and am now doing very well.
My point is that I lead a "full life", playing softball, tennis, etc as a child, went to college, taught school for 21 yrs, etc, etc. My body kept the Lyme in check for the most part.
Then I had surgeries and everything fell apart. If I'd had children, it probably would have fallen apart at that time instead of later when I had surgery.
So I say treat a positive test until no symptoms are present for 2 months or more. I would also pay close attention to the Lyme specific bands. If those are present, don't ignore!
posted
Tree - Falkow was a co-author of both the article in Nature and the one in your link. Go Falkow!!!
Your article is so interesting that it is tempting me to forget the cost of Dell ink cartridges.
Interesting that he was identified in your article (l997) as being associated both with Stanford and the Rocky Mtn. lab, but in my article (2004) only with Stanford. So he is an alumnus of that illustrious lab that was also home to Willie B.
Do you ever get the feeling that the lyme community is better read in the scientific literature than the Steere crowd? Steere fiddles when he should be reading.
Posts: 8430 | From Not available | Registered: Oct 2000
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treepatrol
Honored Contributor (10K+ posts)
Member # 4117
posted
quote:Originally posted by lou: Tree - Falkow was a co-author of both the article in Nature and the one in your link. Go Falkow!!!
Your article is so interesting that it is tempting me to forget the cost of Dell ink cartridges.
Interesting that he was identified in your article (l997) as being associated both with Stanford and the Rocky Mtn. lab, but in my article (2004) only with Stanford. So he is an alumnus of that illustrious lab that was also home to Willie B.
Do you ever get the feeling that the lyme community is better read in the scientific literature than the Steere crowd? Steere fiddles when he should be reading.
Yep and uhhuh
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