posted
my daughter's pcr test just came back positive which I heard is like finding a neeedle in a haystack, but her western blots came back negative. Her lyme doctor said by her standard, the western blots are still positive because there are alot of IND's. Can someone tell me why this happens and does a positive pcr mean you have active lyme now. thanks
Posts: 256 | From Boston, mass | Registered: Jan 2008
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posted
Did you read Dr. C's explanation of the western blot? Think it is in the stickies at the top.
Yes, your daughter hit the jackpot. PCR positive means the spirochete was actually found in her, as opposed to antibodies to it (as in western blot). The problem is that western blots typically don't test for all the possible strains a person might have, and the immune system of chronic cases may no longer be producing antibodies.
Posts: 8430 | From Not available | Registered: Oct 2000
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posted
And in addition to what Lou is saying (good points Lou!). One might also be able to produce antibodies, but when someone is in stage three, they may have a relative high number of antigen (which co-relates to the number of bacteria) and thereby all the antibodies which you are supposed to find with the antibody test are bound up in immunecomplexes.
An immunecomplex is antibodies+antigens.
You can see a image of it here:
The small yellow dots are antigen, and the blue figures are antibodies.
This is well known in early disease.
Naturally (helathy) people very rarely have antibodies when they have never been bit. So when they are bit - and infected - they have more antigen than antibodies.
The antigen comes with the bacteria (in this case Borrelia), and when it's a surplus of antigen - the antibodies which then gets producted (in the very beginning of the disease) are bound up in immune complexes, as you can see here:
Borrelia burgdorferi-specific immune complexes in acute Lyme disease.
Schutzer et al.
CONTEXT: Diagnosis of infection with Borrelia burgdorferi, the cause of Lyme disease (LD), has been impeded by the lack of effective assays to detect active infection.
OBJECTIVE: To determine whether B. burgdorferi-specific immune complexes are detectable during active infection in LD.
DESIGN, SETTING, AND PATIENTS: Cross-sectional analysis of serum samples from 168 patients fulfilling Centers for Disease Control and Prevention surveillance criteria for LD and 145 healthy and other disease controls conducted over 8 years. Tests were performed blinded. MAIN
OUTCOME MEASURE: Detection of B. burgdorferi immune complexes by enzyme-linked immunosorbent assay and Western blot.
RESULTS: The B. burgdorferi immune complexes were found in 25 of 26 patients with early seronegative erythema migrans (EM) LD; 105 of 107 patients with seropositive EM LD; 6 of 10 samples that were seronegative [corrected] with culture-positive EM; 0 of 12 patients who were treated and recovered from LD; and 13 of 13 patients with neurologic LD without EM. Among 147 controls, B. burgdorferi immune complex was found in 0 of 50 healthy individuals; 0 of 40 patients with persistent fatigue; 0 of 7 individuals with frequent tick exposure; and 2 of 50 patients with other diseases.
CONCLUSION: These data suggest that B. burgdorferi immune complex formation is a common process in active LD. Analysis of the B. burgdorferi immune complexes by a simple technique has the potential to support or exclude a diagnosis of early as well as active LD infection.
People with EM are people with a firm clinical diagnosis. And in seronegative patients they find immune complexes. Immune complex formation is the reason why they are seronegative.
But the problem is that the study is on early Lyme. I think that we can see the same thing happen with late Lyme. You then (may) return to a situation when it's a relativly high number of bacteria (and thereby also antigen) and then most of the antigen will be bound up in immune complexes, and you cannot find anything...
Posts: 275 | From Home | Registered: May 2007
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posted
I would say the PCR is definitive and would indicate active Lyme.
-------------------- --Lymetutu-- Opinions, not medical advice! Posts: 96222 | From Texas | Registered: Feb 2001
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Hoosiers51
Frequent Contributor (1K+ posts)
Member # 15759
posted
PCR is very definitive. I don't think it actually finds the live spirochete itself, but it finds DNA of the spirochete.
Was this a urine or blood PCR? Either way, it's definitive. They are either floating around in her blood, or their fragments are being excreted through the urine. So they are there.
If you feel like it, it would be interesting to see which bands she tested positive on with the Western Blot, and which bands she tested IND on...
....because that would give people an idea of how WB's can come back, even when we KNOW someone has Lyme, like in your daughter's case.
I have heard of people testing PCR positive, that only showed band 41 on the WB. Just goes to show how finicky the tests can be. Sheesh.
Best of luck to your daughter!!! Posts: 4590 | From Midwest | Registered: Jun 2008
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Hoosiers51
Frequent Contributor (1K+ posts)
Member # 15759
posted
peter j,
I have been tested for C1Q immune complexes, and was very high on those.
But I wasn't aware there are "bb" immune complexes we can test for?
I would be interested to know the lab that is doing that testing, and if it's available to the general public!
I sent you a PM too, but I decided to respond here as well in case anyone else knows.
Posts: 4590 | From Midwest | Registered: Jun 2008
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posted
The Lab that was used for my daughter's pcr was Igenex Testing in California. Speciality Lab was also used for bartonella testing which came back positive as well and Quest Lab was used for mycoplasma pneumonie and epstein-barr, which also came back positive. The bartonella positive showed in the igg not the igm which her lyme doctor said was still positive with a very high number.
Posts: 256 | From Boston, mass | Registered: Jan 2008
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posted
thanks to all of you that have posted on this site for me, as always, I am always looking for new information out there to help understand this disease. Any information would be greatly appreciated.
Posts: 256 | From Boston, mass | Registered: Jan 2008
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posted
This test was done by blood, not urine and from what I have heard, it is like finding a needle in a haystack so I am lucky to at least find an answer.
Posts: 256 | From Boston, mass | Registered: Jan 2008
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Pinelady
Frequent Contributor (5K+ posts)
Member # 18524
posted
That is a great explaination. I still do not understand why some show Ana and some don't. To my thinking they should all show Ana. Is it a faulty test as well?
-------------------- Suspected Lyme 07 Test neg One band migrating in IgG region unable to identify.Igenex Jan.09IFA titer 1:40 IND IgM neg pos 31 +++ 34 IND 39 IND 41 IND 83-93 + DX:Neuroborreliosis Posts: 5850 | From Kentucky | Registered: Dec 2008
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