posted
Igenex states on there site that Rhematoid disease and EB can interfere with Western Blot. I cannot find any info on that on the web. I did find " some " info to the contrary. Anybody have any idea. If so.many people have positive EB virus with no symptoms and probably have never been checked. This could really raise the # of false positives no??
Posts: 408 | From NY | Registered: Jan 2006
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Aniek
Frequent Contributor (1K+ posts)
Member # 5374
posted
My LLMD has stated multiple times that Igenix can have cross-reactivity. She prefers MDL.
I know many people think MDL is not sensitive enough. I had tested about 20 times negative through quest and the first western blot through MDL was positive.
-------------------- "When there is pain, there are no words." - Toni Morrison Posts: 4711 | From Washington, DC | Registered: Mar 2004
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WOW after checking on the CDC site. They state that approx 95% 0f adults have been exposed to EB virus. This really could interfere with testing don't ya think....
Posts: 408 | From NY | Registered: Jan 2006
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Yeah it could, but lets be honest, the testing sucks as it is.
When a person refers to false positives, and yes they do occur, its a rather complex issue.
First, false positives occur in the sense of usually non Borrelia specific banding patterns with the Western Blot, but they have enough bands to be considered positive.
Secondly, though yes, a whole lotta people have been exposed to the EBV virus, that form of false positivity only refers to active infection with EBV.
So, either ya got some kind of cancer, which can happen, though is not incredibly frequent (EBV is a cause of Lymphoma sometimes)
The main reason this kinda thing occurs in the presense of active Mononucleosis, which is NOT the same thing as having EBV virus detectable in your body.
There is a certain level required to reach an active infection/reinfection with EBV and its rather high, so this kind of false positive Lyme testing thing is really most relavent to teenagers who are just starting to date, ie: kiss, because Mono's the kissing disease.
False positives aren't the problem, false negatives are the problem.
Better yet, Microbiology is the problem, there is no good test that accuratly reflects genetic diversity among borrelia species, accounts for the complex imunological interactions with multiple pathogens, and is specific enough to only test for Borrelia species.
Posts: 559 | From Cary, NC | Registered: May 2006
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posted
OK this is very interesting. Which band would react?? and why does a RA factor interfere?? How namy bands would that interfere with???
Posts: 408 | From NY | Registered: Jan 2006
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posted
So I tested very positive for Epstein Barr and then Igenex positive for Lyme. So, if I am positive for Epstein Barr then I could have a false positive for Lyme?
Posts: 35 | From baltimore, md & nj | Registered: Apr 2006
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posted
Does it need to be active EBV in order for it to affect the Western Blot test for Lyme? It shouldn't right?
If you've been infected with EBV at any point in your life, you would most likely have the antibodies even after the virus has gone dormant right? So, pretty much, if you've ever been infected with EBV (they say 95% of all people have been infected at some point), then this would affect your Western Blot Lyme test. Please correct me if I'm wrong...
Posts: 27 | From CA | Registered: May 2006
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This is what I'm getting at boys and girls...I hope someone has more info. There have been more then 1 report about Igenex having to many positives...Scary
Posts: 408 | From NY | Registered: Jan 2006
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Call Igenex and ask them these questions. They are very helpful and happy to answer questions.
-------------------- Suzanne Shaps STAND UP FOR LYME Texas (www.standupforlyme.org) (Please email all correspondence related to protecting Texas LLMDs to [email protected] with copy to [email protected]) Posts: 977 | From Austin, TX, USA | Registered: May 2004
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Perhaps I didn't explain this false positive thing awell enough in my previous post. To my knowledge, and I'll check on this just in case there has been 1 case, or perhaps 2, that occured in the presence of NON EBV MONO. Perhaps these events occured in Hodgekins Lymphoma or Non Hodgekins Lymphoma, so I'll check on that.
However, for the VAST majority of people who test positive for both diseases. You have Lyme as Lyme is FAR more common than TRUE Chronic Active EBV, which does exist, but is INCREDIBLY UNCOMMON. Check out studies from Baylor University researches on this disease. I can't state enough how INCREDIBLY RARE TRUE CAEBV IS.
So, do these antibodies that currulate in our blood for 95 percent of the worlds population account for false positive Lyme Western blots, NO, unless it meets the exceptions listed above (cancer, Mono, or TRUE CHRONIC ACITVE EPSTEIN BARR VIRUS).
So, I'll reiterate, unless your EBV IgG titer for antibodies exceeds 1:640 IgG, then you don't have a false positive Lyme Western Blot, and even if this is the case where, strangly you do have active EBV at a level above or equal to 1:640IgG, then it still doesn't prove false positivity. You could have both diseases, or a number of other possibilities, ie: infection with HH6 cross reacting with EBV to produce such a titer, and hence you actually have HH6 and Lyme.
The key is with these issues, when they arrise is someone who really does have an EBV titer above or equal to 1:640IgG and a strongly positve Wesern Blot IgG, then more testing is required to hammer out these complex immunological issues.
But, the idea that Igenex has all kinds of extra "positives" because of so many people that have EBV is bogus because that argument only applies to a rather select population.
Igenex has more positives than other labs for Western blots for several reasons. One is the level of exerperience of the staff (they perform these tests A LOT, and this is a test whose accuracy changes with the skill of the technition), 2, they use more than one genetic variant of Borrelia Burgdorferri to account for greater genetic diversity than other labs using strain B31 (a strain of Lyme Disease that blots primarily for ACTIVE Lyme Arthritis but poorly for other forms of Lyme, and for Lyme contracted in areas OTHER than Old Lyme, Conn, and lastly because they include different banding patterns and criteria than other labs.
IGenex lists the full banding patterns for Borrelia, whereas other labs omit Borrelia specific bands such as those used for Vaccine developmen (these are the bands that will not show up on a false positive b/c they happen only in borrelia infections past or present). As Igenex has a positive critera, and the CDC has a positive critera, when one is tested at Igenex, both criteria are used. The critera is less restrictive for Igenex, but both are listed.
So, though I tried to make this a more simple topic, others, who may or may not comprehend the above still question. However, such is life, and I can't say I don't do the same. If you still feel uncertain about how, or why this happens, and don't grasp the above comments, well, if you care that much, its time for you to do the research......my brain's tired now so that's all your getting from me.
Posts: 559 | From Cary, NC | Registered: May 2006
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Lymescience, Thanks so much for your answer. In my case having a high rhematoid factor ( according to Igenex ) can cross react with the western blot. (One small line on their web site ) . I too have looked into it but cannot find too much on this subject,other then responses like " it could " Possibly " rarely" etc regarding RA factor and Lyme tests..So if you have RA, Lupus etc or maybe any autoimmune problem I guess coss reactivity exists. When you look at CFS Fibro, Lyme sites you see many of the same symptoms and many have said that they may all be in the autoimmune family...Thanks again Lymescience
Posts: 408 | From NY | Registered: Jan 2006
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Many RA patients are finding success with antibiotics....So they either have Lyme or some other bacterial agent at work in their bodies.....in my opinion.
-------------------- --Lymetutu-- Opinions, not medical advice! Posts: 96239 | From Texas | Registered: Feb 2001
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quote:Originally posted by 6t5frlane: Lymescience, Thanks so much for your answer. In my case having a high rhematoid factor ( according to Igenex ) can cross react with the western blot. (One small line on their web site ) . I too have looked into it but cannot find too much on this subject,other then responses like " it could " Possibly " rarely" etc regarding RA factor and Lyme tests..So if you have RA, Lupus etc or maybe any autoimmune problem I guess coss reactivity exists. When you look at CFS Fibro, Lyme sites you see many of the same symptoms and many have said that they may all be in the autoimmune family...Thanks again Lymescience
You're very welcome my friend!
Its my understanding that the RA association is much less clear than false positivity on the Western Blot with active Mono where this occurance can be demonstrated in a rather scientific manner(the exclusionairy tests for EBV are excellent, and can be performed with extremely high levels of specificity and sensitivity)
The thinking is that most arthritis(save gout-uric acid) is indeed microbial in nature, so the false positives which have occured in RA patients were likley the result of a related bacterium (likely spirochetal-though it may or may not have been Borrelia in genus), or combination of slow growth bacterial infectious agents.
So, that is quite a difficult immunological conundrum when encountered.
Here is one example of how difficult Arthritis conditions can be to Lyme Diagnosis when they co-exist.
My father has gout. Gout is relativly simple to dianose, though most people think it can be diagnosed easily through a blood test, this is not exactly true.
Gout can be definitivly diagnosed durring an attack. A buildup of fluid is usually present durring such an attack, and a needle can extract the fluid to look for the uric acid cystals- confirmation of Gout.
Well, my father started having other arthritis problems that were a bit different from his normal gout(which was painful to the touch), and his rhumatologist assumed his gout had spread to other joints (not a far fetched idea, this kind of thing is very well documented). However, my father also had other symptoms, which were not common in gout, so being Lyme litterate, I had him tested on the Western Blot IgM and IgG for Lyme.
He was highly positive on both for the CDC and Igenex criteria for both the IgG and IgM.
Now, how did we asses Dad's condition in this difficult clinical case.
We had to look at the banding pattern, and we had to see his response to antibiotics. The big clues in the differential in my father's case were his strongly postive bands in Borrelia genus specific bands. This would not be expected to occur in a gout false positve Western Blot.
Second, my father had definite herxheimers in response to antibiotics, though he claimed he did not.
How can I say he did, well I asked him in good detail about everything he felt after taking his medicine, and sure enough, a few hours after antibiotics, he was in terrible pain, and his legs begain to burn in a stinging sort of way. Then he would have shooting pains down both his legs, and he would get somewhat tired.
But, he did not have a great idea of what a herx actually was, so to him, he had just worked too hard, or "fill in the blank"
So, I hope this helps you to understand the things to be looking for when you encounter this difficult diagnositic scenerio.
Also, improvement is not gaurenteed on one antibiotic such as Doxycycline. My advice is that if things are not improving, you must take the initiative to find out why. That includes trying a larger dose, trying a smaller dose, changing drugs, trying to combine drugs.
Please feel free to ask any questions you have. If it turns out you don't have Lyme, and you do have something else, thats perfectly fine. Myself and others are not here to convince everyone that they have Lyme. The important thing is to make sure one does have Lyme or at the very least a strong probability of Lyme (ask us if you are unsure), then the next is finding a treatment aproach that works. Don't be discouraged if the first doesn't.
In lyme, this adage is very important to recovery, "if at first you don't succeed, try try again."
Posts: 559 | From Cary, NC | Registered: May 2006
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posted
Well the heck with it...I'll post them from last Feb
Igenex
IGG all neg except 41 which was IND
IGM Positive on the following bamds
23-25++ 34 IND 39+ 41+ 66+ 93+ According to them both CDC and Igenex positive
Recent (May )Quest testing showed a Neg western blot but poitive Elisa? My RA factor was very high also,so thats my dilema and Neg on co infections
Posts: 408 | From NY | Registered: Jan 2006
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posted
Sorry it has taken me so long to respond, I had a bad herx yesterday that put me out of commission.
Let me check your banding pattern, do some searching, and I'll give ya the best answer I can.
Remember though, that I'm not a medical doctor, and though I do understand a lot about Lyme, I'm not perfect.
However, I will try to help, so check back sometime today, and you'll see my response.
Posts: 559 | From Cary, NC | Registered: May 2006
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posted
I found a good eplanation for you. If you don't understand something, just ask and someone will come along to help.
From your banding pattern it would appear you have early localized Lyme-which can be treated if done correctly.
Now, from my own evaluation, it appears you have a very HIGH liklihood of Lyme Disease because you reacted so strongly to Outer Surface Protein C, that is Borrelia specific. But, don't take my word for it, read on.
Explanation of the Lyme Disease Western Blot by Carl Brenner Inquiries about various issues relating to Western blot (WB) testing are frequently posted to the Lyme disease discussion groups on the Internet. Among the most commonly asked questions are:
* What laboratory techniques are used to carry out the assay? * What exactly is being measured? * What is a "band"? * How are the results interpreted? * What are the CDC criteria for a "positive" test?
Although some of the medical jargon associated with immunology can be a little overwhelming, the scientific principles behind these tests are not difficult to grasp. The following article is offered as a primer in the techniques and interpretation of Western blotting, and should help most patients navigate their way through some of the medical and scientific terminology associated with the assay.
First of all, it should be noted that the Western blot is usually performed as a follow-up to an ELISA test, which is the most commonly employed initial test for Lyme disease. "ELISA" is an acronym for "enzyme-linked immunosorbent assay." There are ELISA tests and Western blots for many infectious agents; for example, the usual testing regime for HIV is also an initial ELISA followed by a confirmatory Western blot.
Both the ELISA and the Western blot are "indirect" tests -- that is, they measure the immune system's response to an infectious agent rather than looking for components of the agent itself.
In a Lyme disease ELISA,
1. antigens (proteins that evoke an immune response in humans) from Borrelia burgdorferi (Bb) are fixed to a solid-phase medium and 2. incubated with diluted preparations of the patient's serum. If antibodies to the organism are present in the patient's blood, they will bind to the antigen. 3. These bound antibodies can then be detected when a second solution, which contains antibodies to human antibodies, is added to the preparation. Linked to these second antibodies is an enzyme which changes color when a certain chemical is added to the mix.
Although the methodology is somewhat complicated, the basic principle is simple: the test looks for antibodies in the patient's serum that react to the antigens present in Borrelia burgdorferi. If such antibodies exist in the patient's blood, that is an indication that the patient has been previously exposed to B. burgdorferi.
However, many different species of bacteria can share common proteins. Most Lyme disease ELISA's use sonicated whole Borrelia burgdorferi -- that is, they take a bunch of B. burgdorferi cells and break them down with high frequency sound waves, then use the resulting smear as the antigen in the test. It is possible that a given patient's serum can react with the B. burgdorferi preparation even if the patient hasn't been exposed to Bb, perhaps because Bb shares proteins with another infectious agent that the patient's immune system *has* encountered. For example, some patients with periodontal disease, which is sometimes associated with an oral spirochete, might test positive on a Lyme ELISA, because their sera will react to components of Bb (like the flagellar protein, which is shared by many spirochetes) even though they themselves have never been infected with Bb. Therefore, some positive Lyme disease ELISA results can be "false" positives.
To distinguish the false positives from the true positives, a more specific laboratory technique, known as immunoblotting, is used.
* The Western blot, which identifies specific antibody proteins, is but one kind of immunoblot; * there is also a Northern blot, which separates and identifies RNA fragments, * and a Southern blot, which does the same for DNA sequences.
In a Western blot, the testing laboratory looks for antibodies directed against a wide range of Bb proteins.
1. This is done by first disrupting Bb cells with an electrical current and then "blotting" the separated proteins onto a paper or nylon sheet. The current causes the proteins to separate according to their particle weights, measured in kilodaltons (kDa). 2. From here on, the procedure is similar to the ELISA -- the various Bb antigens are exposed to the patient's serum, and reactivity is measured the same way (by linking an enzyme to a second antibody that reacts to the human antibodies).
If the patient has antibody to a specific Bb protein, a "band" will form at a specific place on the immunoblot. For example, if a patient has antibody directed against outer surface protein A (OspA) of Bb, there will be a WB band at 31 kDa. By looking at the band pattern of patient's WB results, the lab can determine if the patient's immune response is specific for Bb.
Here's where all the problems come in. Until recently, there has never been an agreed-upon standard for what constitutes a positive WB. Different laboratories have used different antigen preparations (say, different strains of Bb) to run the test and have also interpreted results differently.
* Some required a certain number of bands to constitute a positive result, * others might require more or fewer. * Some felt that certain bands should be given more priority than others. * In late 1994, the Centers for Disease Control and Prevention (CDC) convened a meeting in Dearborn, Michigan [1] in an attempt to get everybody on the same page, so that there would be some consistency from lab to lab in the methodology and reporting of Western blot results.
Before we get to the recommendations that resulted from this meeting, we need to understand one more facet of the human immune response. Many patients have noticed that their Western blot report usually contains two parts: IgM and IgG. These are immunoglobulins (antibody proteins) produced by the immune system to fight infection.
1. IgM is produced fairly early in the course of an infection, while 2. IgG response comes later.
Some patients might already have an IgM response at the time of the EM rash; IgG response, according to the traditional model, tends to start several weeks after infection and peak months or even years later. In some patients, the IgM response can remain elevated; in others it might decline, regardless of whether or not treatment is successful.
Similarly, IgG response can remain strong or decline with time, again regardless of treatment. Most WB results report separate IgM and IgG band patterns and the criteria for a positive result are different for the two immunoglobulins.
Finally, in setting up a nationwide standard for a positive WB, one makes several assumptions --
1. that all strains of Bb will provoke similar immune responses in all patients, 2. that all patients will mount a measurable immune response when exposed to Bb, and 3. that the IgG immune response will persist in an infected patient.
Unfortunately, none of these is always true. Therefore, a judicious interpretation of Western blot results in a clinical setting should take into account both
1. the vagaries of the human immune response and 2. the possibility that strain variations in Bb might produce unusual banding patterns.
The CDC criteria for a positive WB are as follows:
* For IgM, 2 of the following three bands: OspC (22-25), 39 and 41. * For IgG, 5 of the following ten bands: 18, OspC (22-25), 28, 30, 39, 41, 45, 58, 66 and 93.
How were these recommendations arrived at? The IgG criteria were taken pretty much unchanged from a 1993 paper by Dressler, Whalen, Reinhardt and Steere [2]. In this study, the authors performed immunoblots on several dozen patients with well characterized Lyme disease and a strong antibody response and looked at the resulting blot patterns. By doing some fairly involved statistical analysis, they could determine which bands showed up most often and which best distinguished LD patients from control subjects who did not have LD. They found that by requiring 5 of the 10 bands listed, they could make the results the most specific, in their view, without sacrificing too much sensitivity. ("Sensitivity" means the ability of the test to detect patients who have the disease, "specificity" means the ability of the test to exclude those who don't. Usually, an increase in one of these measures means a decrease in the other.) The IgM criteria were determined in much the same fashion (by different authors in different papers). Fewer bands are required here because the immune response is less mature at this point. Several studies have shown that
1. the first band to show up on a Lyme disease patient's IgM blot is usually the one at 41 kDa, 2. followed by the OspC band and/or the one at 39.
The OspC and 39 kDa band are highly specific for Bb, while the 41 kDa band isn't. That's why the 41 by itself isn't considered adequate. Here's the rub, though: the CDC doesn't want the IgM criteria being used for any patient that has been sick for more than about six weeks. The thinking here is that by this time an IgG response should have kicked in and the IgM criteria, because they require fewer bands, are not appropriate for patients with later disease.
A number of criticisms have been offered of the CDC criteria since their adoption in 1994.
1. The first is centered on the CDC's failure to make any qualitative distinction among the various bands that can show up on a patient's Western blot. A number of Lyme disease researchers feel that different bands on a WB have different relative importance -- that "all bands are not created equal." For example, * many patients with Lyme disease will show reactive bands at, say, 60 and/or 66 kDa. However, these correspond to common proteins in many bacteria, not just Borrelia burgdorferi, and so are of limited diagnostic usefulness, especially in the absence of other, more species-specific bands. The band at 41 kDa corresponds to Bb's flagella (the whip like organelles used for locomotion -- Bb has several) is one of the earliest to show up on the Western blots of Lyme disease patients. But for some reason it is also the most commonly appearing band in control subjects. This may be due to the fact that many people are exposed to spirochetes at some time in their lives and so their sera might cross react with this protein.
* On the other hand, certain other bands are considered highly specific for Bb -- the aforementioned o 31 kDa band, for example, or o 34 (OspB) or o 39 or OspC (anywhere between 22 and 25). Also thought to be species-specific are o The 83 and o 94 kDa bands. Many Lyme disease scientists believe that any patient whose IgG Western blot exhibits bands at, say, any three (or even two) of these locations almost certainly has Lyme disease, regardless of whether or not any other bands are present. They feel that these bands on a Lyme Western blot are simply more meaningful than other, less specific ones and that a rational interpretation of a WB result should take this into account. Unfortunately, this does not often happen, and will happen even less with the new CDC criteria.
2. A second criticism of the CDC Western blot criteria is that they fail to include the 31 and 34 kDa bands. This does indeed seem like an odd decision, since antibodies with these molecular weights correspond to the OspA and OspB proteins of B. burgdorferi, which are considered to be among the most species-specific proteins of the organism. So why didn't Dressler et al. include them? Answer: These bands tend to appear late if at all in Lyme disease patients, and did not show up with great frequency in the patients that the Dressler et al. group studied (though they did show up sometimes). As a result, they weren't deemed to have much diagnostic value and didn't find their way onto the CDC hot list. However, * while the absence of either of these bands from a patient's immunoblot result does not rule out Lyme disease, * their presence is hardly meaningless. Thus, many Lyme disease experts believe it is a serious mistake to exclude these two antibody proteins from the list of significant bands. The CDC's decision to do so seems particularly strange in light of the fact that it is the OspA component of Bb that is being used as the stimulating antigen in the ongoing experimental Lyme disease vaccine trials. As one immunologist remarked shortly after the 1994 CDC conference, "If OspA is so unimportant, then why the heck are we vaccinating people with it?"
3. Finally, it is important to keep in mind that no matter how carefully the Western blot test is carried out and interpreted, its usefulness, like that of all tests that measure B. burgdorferi antibodies, is ultimately contingent on the reliability of the human immune response as an indicator of exposure to B. burgdorferi. There are several scenarios in which the lack of a detectable antibody response may falsely suggest a lack of B. burgdorferi infection. 1. First, it is well established that early subcurative treatment of Lyme disease can abrogate the human immune response to B. burgdorferi [3]. Although this is not thought to be a common phenomenon, a recent comparative trial for the treatment of erythema migrans found that a majority of patients who failed early treatment and suffered clinical relapse were seronegative at the time of relapse [4]. Even treatment for disseminated Lyme disease, in which the patient's IgG immune response was previously well-established, can render a patient seronegative after treatment despite post-treatment culture-positivity for B. burgdorferi [5, 6]. 2. In addition, patients with Lyme disease may not test positive for exposure to B. burgdorferi because their antibodies to the organism are bound up in immune complexes [7]. Once steps are taken to dissociate these immune complexes, free antibody can be detected; however, this is not routinely done when performing serologic tests for Lyme disease. 3. Finally, an indeterminate number of patients with late Lyme disease are simply seronegative for unknown reasons [8]. The actual percentage of such cases as a proportion of all Lyme disease cases is impossible to estimate, since most studies of late Lyme disease enroll only seropositive patients, which tends to reinforce the circular and erroneous notion that virtually all patients with late Lyme disease are seropositive. 4. It should also be noted that a positive Western blot is not necessarily an indication of active Lyme disease. A patient's immune response to B. burgdorferi can remain intact long after curative treatment for a Lyme infection; therefore, the results of a Western blot assay should always be interpreted in the context of the total clinical picture.
Addendum by Joachim Gruber: Carl Brenner is one of 2 patients who sit on the National Institute of Allergy and Infectious Diseases (NIAID) Advisory Committee for Clinical Studies on Chronic Lyme (information from Ramp S, The dirty truth behind Lyme disease research, Lyme Times 26,7, 1999). REFERENCES [1] Proceedings of the Second National Conference on Serologic Diagnosis of Lyme Disease, October 27-29, 1994. [2] Dressler F, Whalen JA, Reinhardt BN, Steere AC. Western blotting in the serodiagnosis of Lyme disease. J Infect Dis 1993;167:392-400. [3] Dattwyler RJ, Volkman DJ, Luft BJ et al. Seronegative Lyme disease: dissociation of specific T- and B-lymphocyte responses to Borrelia burgdorferi . N Engl J Med 1988;319:1441-6. [4] Luft BJ, Dattwyler RJ, Johnson RC et al. Azithromycin compared with amoxicillin in the treatment of erythema migrans. Ann Intern Med 1996;124:785-91. [5] H�upl T, Hahn G, Rittig M, et al. Persistence of Borrelia burgdorferi in ligamentous tissue from a patient with chronic Lyme borreliosis. Arth Rheum 1993;36:1621-6. [6] Preac-Mursic V, Marget W, Busch U, Pleterski Rigler D, Hagl S. Kill kinetics of Borrelia burgdorferi and bacterial findings in relation to the treatment of Lyme borreliosis. Infection 1996;24:9-18. [7] Schutzer SE, Coyle PK, Belman AL, et al. Sequestration of antibody to Borrelia burgdorferi in immune complexes in seronegative Lyme disease. Lancet 1990;335:312-5. [8] Liegner KB. Lyme disease and the clinical spectrum of antibiotic responsive chronic meningoencephalomyelitides. (Abstract, 1996 LDF Conference, Boston. MA) Location of this page. Home Version: February 6, 2000.
Posts: 559 | From Cary, NC | Registered: May 2006
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WOW Thanks....I have read about the Wetern Blot test before from the info for the Newbies. When I took the test from Igenex I was already symptomatic for 6 months. IGM Pos IGG neg. One would think I would be IGG pos right ? I have also heard that the IGM and IGG can go back and forth with this disease. The fact that the 39 band showed up interests me,even with the very high Ra factor. What about the 93 band??? Even with that great answer Lymescience I see nothing about Ra factors and western Blots for Lyme. So did I cross react? or am I Lyme Pos? Next question...Iwas on abx for 5 days before that test which I understand is correct. If I decide to do it again ABX yes or ABX no before the test...Sorry for so many questions but I'm very sick and looking for answers.....6t5
Posts: 408 | From NY | Registered: Jan 2006
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"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."
This is written by a man who has treated WELL OVER 1,000 Lyme patients! Please listen!
============================================
Because RA patients also respond to abx, what are you waiting for? Your body needs help and it needs it now.
I just saw that you are taking doxy. How much? 400-600 mg a day??
Any chance your dr will change abx soon??
-------------------- --Lymetutu-- Opinions, not medical advice! Posts: 96239 | From Texas | Registered: Feb 2001
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posted
I take doxy 2x a day was 3x but tummy ( even with probiotics ) said no. So far really no improvement. Considering getting the testing done again ( expensive ) but it's my health and I'm worried. Can you answer the ABX question yes or no before Western Blot testing ?? Thanks again for ALL your time
Posts: 408 | From NY | Registered: Jan 2006
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Sewer Rat
Unregistered
posted
quote:Originally posted by 6t5frlane: Igenex states on there site that Rhematoid disease and EB can interfere with Western Blot. I cannot find any info on that on the web. I did find " some " info to the contrary. Anybody have any idea. If so.many people have positive EB virus with no symptoms and probably have never been checked. This could really raise the # of false positives no??
Not really, because the nonspecific bands are not counted. Igenex uses "whole-cell"-immunoblots, and with such tests cross-reactivity is normal.
Band 41kD is nonspecific and can cross-react with other spirochetes, EBV and CMV. So a positive band 41kD isn't counted as a specific band.
I don't know with which band(s) RF can cross-react, but you have to trust that Igenex takes that into account.
Specific bands are 25kD and 39kD, which you have in WB-IgM, which makes your WB-IgM positive. Your WB-IgG is negative, though.
Positive IgM counts heavier than positive IgG, because IgM is indicative of recent infection.
quote:Originally posted by Lymetoo: What else could possibly cause band 39 to show up than Lyme? NOTHING!
Antibodies against Treponema pallidum (syphilis) can slightly cross-react with band 39kD, and other bands as well.
quote:Originally posted by 6t5frlane: If I decide to do it again ABX yes or ABX no before the test
You don't need to stop taking doxy for a while, if that is what you mean. You can take tests any time: before, during or after a course of ABX. The ABX won't interfere with the tests.
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whoops...Somehow hit "New Topic "...Anyway I'm sure Igenex does not consider other conditions or disease since there are so many. I guess I'll give em a call and see what bands would cross react
Posts: 408 | From NY | Registered: Jan 2006
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posted
If band 39 cross reacts with syphillus.... no problem, It's treated with abx as well.
I disagree that you can keep taking the abx before the test. Dr C in the link above says to stop at least two weeks before the test for the best results.
I see no reason for getting tested again. You have the answer you need....but if it makes you feel better, then do it.
I don't feel doxy is the best drug after the first month or so. It's good for making sure ehrlichiosis is not a problem. But after that, many of the other drugs are more effective.
You can get the dosages up higher since the others are not so tough on the stomach.
-------------------- --Lymetutu-- Opinions, not medical advice! Posts: 96239 | From Texas | Registered: Feb 2001
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Sewer Rat
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posted
quote:Originally posted by 6t5frlane: Anyway I'm sure Igenex does not consider other conditions or disease since there are so many.
It is known which bands are specific and which are nonspecific. The specific bands can only (slightly) cross-react with just a few things.
Therefore, multiple specific bands make the chance of false positivity very small. In other words: a positive WB has a very high specificity, unless the lab has bad tests and/or bad personnel.
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Sewer Rat
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quote:Originally posted by Lymetoo: I disagree that you can keep taking the abx before the test. Dr C in the link above says to stop at least two weeks before the test for the best results.
You are right, he says: "Sometimes multiple antibiotics have to be tried before the patient feels better. Antibiotics may actually help with the laboratory diagnosis. But patients need to be off antibiotics about 10 to 14 days before the Western blot is repeated. This sounds like a contradiction.
Antibiotics may help convert the test to positive, but patients need to be off antibiotics when the specimen is drawn.
It is well documented in medical literature that the presence of antibiotics may cause false negative borreliosis testing. Therefore, your system should be free of all antibiotics for an accurate blot result."
I would like to see those medical literature. Anyone?
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posted
Actually, that is incredilby well documented regaring false negative seriology, but, and I will have to check on this, its my understanding that those tests refer only to very early in the disease when one takes antibiotics which don't kill the infection, and thus creates an "everybody agrees" false negative and true negative seriologly Lyme desease.
I'll have to check on data other than that, but that is all I know for fact.
Posts: 559 | From Cary, NC | Registered: May 2006
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quote:Originally posted by Sewer Rat: Antibiotics may help convert the test to positive, but patients need to be off antibiotics when the specimen is drawn.
I don't know, but my first WB had one or two bands show up. I took abx for 3 weeks, after which 6 bands showed up. Worked for me.
[I DID stay off abx the two weeks prior to the second test.]
-------------------- --Lymetutu-- Opinions, not medical advice! Posts: 96239 | From Texas | Registered: Feb 2001
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Sewer Rat
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posted
quote:Originally posted by Lymetoo: I don't know, but my first WB had one or two bands show up. I took abx for 3 weeks, after which 6 bands showed up. Worked for me.
When you take ABX, the pieces of killed Bb can stimulate an immune response. Possibly that happened in your case.
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treepatrol
Honored Contributor (10K+ posts)
Member # 4117
posted
The reason bands show up after abx's is that when you kill or send Bb into cysts the mass of antibodies that were attached to the spirochetes are set free because those particular spirochetes are dead thus freeing pieces & parts of spirochetes & antibodies up and your body starts to pass them out of system ie blood urine etc.
-------------------- Do unto others as you would have them do unto you. Remember Iam not a Doctor Just someone struggling like you with Tick Borne Diseases.
posted
Hi Lymeytutu and Lymescince, was wondering if you could give me a little expertise as well.. This thought has also made me ponder as to if I am postive or false pos. I was sick one year prior to all this with a postive EBV in 98 and went through mono..half a year later I fell Chronically ill.. Any feedback would be greatly appreciated..I have been sick for 7 years this May and was tested in 7-20-05..I was originally dx'd with CFS at Mayo Clinic in 99' due to a elevated protein level in my spinal fluid..I have been to 2 of the best CFS dr's in the Nation and neither did to much for me. One in Ashville, NC. and one in Incline Village, NV. I am currently taking a beta interferon for my immune system through my CFS doc. and have seen improvements in my test results, but none to my symptoms..I was dx'd from a LLMD out here about 3 months ago, but I still feel like I need your input..I never had a bullseye rash that I can remember but had been bitten by several ticks, mostly dog ticks..I will list my Igenex lab results and would love your feedback..I live in Nebraska, which is not a endemic area, but Iowa and Minnesota aren't that far away and they are..My doc is good, he is young but his father owns Igenex so i would think that he knows what he is doing..Thanks again for any input..I have been on Omnicef 1200mgs a day and 1000 mgs of probenecid along with Nystatin and probiotoics for about 3 months now..The first 2.5 were hell, extreme fatigue, even worse cognitive problems, extreme muscle twitching and shooting pains in my legs, night sweats and pains in my teeth.. and now I feel abit better, not sure if the meds were making me sick or if I went through a really bad HERX. Whatever it was wasnt fun at all..
IGG WB Igenex Negative 30 IND 31 IND 39 IND 41 ++ 58 IND The rest are all NEG.
IGM WB Igenex Postive through Igenex and CDC but this is 6 years after I became ill. So from what I read they would throw this out. 18 ++ 30 IND 31 IND 39 + 41 ++ 58 IND 66 + 93 + Rest are Neg.
Posts: 9 | From Nebraska | Registered: Jun 2006
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Sewer Rat
Unregistered
posted
quote:Originally posted by treepatrol: The reason bands show up after abx's is that when you kill or send Bb into cysts the mass of antibodies that were attached to the spirochetes are set free because that particular spirochete is dead thus freeing antibodies up and your body starts to pass them out of system ie blood urine etc.
How do you know that? I would rather suspect the antibodies to stay in antibody-antigens complexes.
The ABX kills Bb, and pieces of killed Bb (antigens) can stimulate an immune response.
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posted
I found it interesting that Scotland recently added band 58 as being lyme specific, and thereby increased the number of positive test results/reported cases. I was positive on that band, and have been told that because of my severe back problems, I had a "european" type strain. Not that it is restricted to Europe however. Obviously not, since I was bitten in the U.S.
To me this says again that testing is not an exact science and they don't really know enough about genetic diversity of the kete, nor is it covered by most lab testing.
Someone said at the time of the Scotland band change criteria that German scientists had already designated band 58 as significant in lyme.
Posts: 8430 | From Not available | Registered: Oct 2000
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posted
Sewer rat..." It is known which bands react "...By whom may I ask. Like I said I just don'trust that any lab can ck for so many things that can cross react. I' guess I'm trying to get REAL facts here not just opinions ( which I thank you all for ).
Posts: 408 | From NY | Registered: Jan 2006
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bettyg
Unregistered
posted
quote:Originally posted by Sewer Rat:
quote:Originally posted by treepatrol: The reason bands show up after abx's is that when you kill or send Bb into cysts the mass of antibodies that were attached to, the spirochetes are set free because that particular spirochete is dead thus freeing antibodies up and your body starts to pass them out of system ie blood urine etc.
How do you know that? I would rather suspect the antibodies to stay in antibody-antigens complexes.
The ABX kills Bb, and pieces of killed Bb (antigens) can stimulate an immune response.
Sewer rat, since you are brand new to the board, I do not understand where you are coming from and your questioning TREEPATrol THIS WAY.
Tree has posted here to HELP folks trying to use user-friendly language for us all to understand better lyme disease.
SR, what is your current occupation please? Do you have a medical background? Just curious based on the brief comment you made here.
Treepatrol has compiled NEWBIE LINKS in medical, so please go there and read ALL the good info he has compiled from reputable web sites and our lymenet members. ok. You've got months ahead of you reading there! LOL. Bettyg
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Sewer Rat
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posted
quote:Originally posted by 6t5frlane: Sewer rat..." It is known which bands react "...By whom may I ask. Like I said I just don'trust that any lab can ck for so many things that can cross react. I' guess I'm trying to get REAL facts here not just opinions ( which I thank you all for ).
My statements are based on either facts or well-informed carefully thought out opinions.
The information about Western blot bands on this page is based on medical literate.
posted
I believe this is a forum for discussion that can include differences in interpretation, as long as everyone stays non-confrontational and tries to dig up facts rather than opinion. Since most of us are not professionals in the fields concerned with lyme, there are going to be differences. This is not a problem to me. We can all learn from each other. Sometimes the facts that we look for are not even known to the professionals or THEY disagree in their interpretations. Finding solid ground with tickborne diseases is difficult.
Posts: 8430 | From Not available | Registered: Oct 2000
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Obviously this is a considerable interest to many, and to sewer rat, welcome to Lymenet.
I must say that while your time here has been short, you havn't been as "rude" as I was when I first posted. Also, I must also imphasize that Treepatrol does know what he's speaking, and frankly, I think his work speaks for itself.
My point is this, when you start out geeking on Lyme research (and I'm a huge geek) you mostly stick to pubmed, and this should be your main source of info, granted you read scientific articles with a skeptical eye for language.
However there are reams of published and unpublished material relating to Lyme, and still subjected to the scruitiny of the scientific method.
Here's one good example, the journal articles from the Journal of Spirochetal and related Diseases can't be picked up on pubmed, but it is a peer reviewed (and not just from the pro Lyme side, it was peer reviewed also by the likes of folks who work with Alan Barbour) journal filled with information that's hard to find elsewhere. This is the kind of stuff one gets to reading when you move from Lyme geek, to Lyme super geek. Being that Treepatrol has been here so long, I'd say he's a super geek (actually a compliment Tree).
So, while differences of opinion are needed, we can do so agreeably, and I don't think you were out of line or rude, so I'm not putting that on you, but prolly best not to go haywire like I did a few days ago when I thought I was speaking to a troll who happened to be a Lyme patient with a bad attitude, so.....
I can say from experience, that its best to be aggreable as much as one can, that is until you've been here a while, and, well, you can kinda loose it all to hell every once and a while. I did that just the other day:)
Posts: 559 | From Cary, NC | Registered: May 2006
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quote:Originally posted by treepatrol: The reason bands show up after abx's is that when you kill or send Bb into cysts the mass of antibodies that were attached to the spirochetes are set free because that particular spirochete is dead thus freeing antibodies up and your body starts to pass them out of system ie blood urine etc.
How do you know that? I would rather suspect the antibodies to stay in antibody-antigens complexes.
The ABX kills Bb, and pieces of killed Bb (antigens) can stimulate an immune response.
You're both correct, and yet, there may be other reasons for this occurance. For exmaple, its well known, and well documented in the scientific literature that Lyme antigens can stimulate an immune response, however, its also well known AND well documented that the same thing can happen, and has been proven (though there was one paper that disputed this, but it has not been repeated) that Tree is also correct to say that at times antibodies are not detected because they surround the Borrelia complex(those that are available) and these antibodies are indeed bound in an antibody complex.
There are far too many questions regarding the exact mechanism or combination of mechanisms as pertains to individual people.
For example, it is well documented that in later stages of Lyme Diseaese (arthritic and nueroborriliosis, though I'm not certain about ACA which would be dermatological) that the immune system is put into a position wherby Borrelia co-exists AND causes autoimmunity, which is very strange.
So, while Borrelia modulates the immune system so that white blood cells don't arbogate a stong immune response against Borrelia (though you may find people who dissagree with this premice citing literature from Steere on Lyme arthritis) it also causes damage to other cells in ways that are not yet well understood.
So, given the facts we do have, its plausable that for certain people, antibodies are bound to whole cell spirochetes and when antibiotics kill the spirochete, the antibodies are freely found within western blot testing and would not be expected to be formed because of antigenic stimulus because of the preexisting immune deficiency relating to Borreliosis of later stages in certain people.
In other words, this stuff aint easy, and clearly both answers can be correct depending on the particulars of the clinical case, and in some cases both may be true.
Posts: 559 | From Cary, NC | Registered: May 2006
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posted
SR thanks again for chiming in...BUT...we are back at square one. CK the Igenex site that you gave and it shows what bands they use to ck for Lyme but again states that RA factor and EB can cross react ( My first post question ). It does Not say anything else or give any info on them Checking for such things before testing....
Posts: 408 | From NY | Registered: Jan 2006
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Sewer Rat
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posted
quote:Originally posted by bettyg: Sewer rat, since you are brand new to the board, I do not understand where you are coming from and your questioning TREEPATrol THIS WAY.
I just ask a question, because I never heard about that before. If treepatrol can point me to literature about it, then I would like to read it.
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Sewer Rat
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posted
quote:Originally posted by 6t5frlane: SR thanks again for chiming in...BUT...we are back at square one. CK the Igenex site that you gave and it shows what bands they use to ck for Lyme but again states that RA factor and EB can cross react ( My first post question ). It does Not say anything else or give any info on them Checking for such things before testing....
Back at square one? Were al our efforts in vain?
I responded to your "I guess I'm trying to get REAL facts here not just opinions".
So, have you seen the information about Western blot bands on this page, which is based on medical literate?
I posted the page of Igenex because that's the lab that did your testing. Please ignore it if it brings you back to "square one".
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quote:Originally posted by 6t5frlane: SR thanks again for chiming in...BUT...we are back at square one. CK the Igenex site that you gave and it shows what bands they use to ck for Lyme but again states that RA factor and EB can cross react ( My first post question ). It does Not say anything else or give any info on them Checking for such things before testing....
I would actually dissagree with this statement, though I don't mean this in a rude manner. We have covered the Epstein Barr Virus in detail, and this is a disease in which I'd consider myself a geek (meaning that I've read about 40 to 50 full leagnth scientific articles and have read at least the last 3 years international EBV conferences)
As far as I know, I have listed the exceptions regarding EBV as I'm rather well informed regarding the Life cycle of EBV in the normal human being, and when not in the normal situation, for example in somone who has Chronic EBV- again an incredibly rare condition (I'll post some general links for this in a bit, and I'll also post a link showing the life cycle of EBV in the host and then I'll see if I can find one that delineates to the unusual case of cancer, active MONO, or SCAEBV)
So, while I am almost certain that these would be your only exceptions, I'll look again, but my feeling is that the EBV thing has been extensivly well covered.
The reason I know so much about EBV is that, similar to one patient who reported having MONO, I was said to have had mono as well. I did have a titer of 1:640, which is diagnostic of an active infection, BUT, I had no circulating EBV DNA which is HIGHLY unusual for true SCAEBV. For these middle of the road cases, the diagnositic criteria is usually bumped up to something like a IgG titer of 1:1000 or more.
But, for those who wish to read the mundane activities regarding EBV, and some of the genuinely interesting activities of the imunological profile of this common, and complicated virus, I will soon post some info to read.
Also, I highly encourage others to look to see if it is possible for someone to not have a rare EBV related condition of active infection (though its really always an active infection, but thats incredibly technical) and just have once had mono, but no longer having any symptoms from mono, and yet have a false negative Lyme Western Blot, and if so, is it also possible to have a Western blot in this condition with several Lyme specific bands.
Now, until someone can find this, I'm gonna go ahead and say Occam's razor, nuff said.
Posts: 559 | From Cary, NC | Registered: May 2006
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British Journal of Haematology Volume 112 Page 377 - February 2001 doi:10.1046/j.1365-2141.2001.02550.x Volume 112 Issue 2
Short Report Fatal atypical T-cell proliferation associated with Epstein-Barr virus infection Steffen Hauptmann,1 Nadine Meru,2 Christiane Schewe,1 Andreas Jung,2 Falk Hiepe,3 Gerd R�diger Burmester,3 Gerald Niedobitek2 and Frank Buttgereit3
We report the case of a young Caucasian man who presented with polyneuropathy and severe, ultimately fatal, congestive heart failure in the context of a chronic active Epstein-Barr virus (EBV) infection. Post-mortem examination revealed both monoclonal and polyclonal proliferation of EBV-positive atypical T lymphocytes within different organs. Predominant infiltration of the nervous system and heart with extensive myocardial scarring accounted for the clinical symptoms. The remarkable features of this case are (i) the occurrence in a Caucasian patient, (ii) the absence of detectable immunodeficiency, and (iii) the myocardial destruction by EBV-infected monoclonal T cells.
Thats just the first, to give ya a taste of what you're in for. SCAEBV can be deadly, and note that they say how strange it was for a white guy to have this condition, this disease almost exclusivly occurs in people from Japan and the sourouding area.
Posts: 559 | From Cary, NC | Registered: May 2006
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