Blood test
Blood test
Lyme disease organism, Borrelia burgdorferi
Lyme disease organism, Borrelia burgdorferi
Deer ticks
Deer ticks
Ticks
Ticks
Lyme disease - Borrelia burgdorferi organism
Lyme disease - Borrelia burgdorferi organism
Tick imbedded in the skin
Tick imbedded in the skin

Lyme disease antibody

Definition:
These tests are used to confirm the diagnosis of Lyme disease.

Alternative Names:
Lyme disease serology; ELISA for Lyme disease; Western blot for Lyme disease

How the test is performed:

Adult or child:
Blood is drawn from a vein (venipuncture), usually from the inside of the elbow or the back of the hand. The puncture site is cleaned with antiseptic, and a tourniquet (an elastic band) or blood pressure cuff is placed around the upper arm to apply pressure and restrict blood flow through the vein. This causes veins below the tourniquet to distend (fill with blood). A needle is inserted into the vein, and the blood is collected in an air-tight vial or a syringe. During the procedure, the tourniquet is removed to restore circulation. Once the blood has been collected, the needle is removed, and the puncture site is covered to stop any bleeding.

Infant or young child:
The area is cleansed with antiseptic and punctured with a sharp needle or a lancet. The blood may be collected in a pipette (small glass tube), on a slide, onto a test strip, or into a small container. Cotton or a bandage may be applied to the puncture site if there is any continued bleeding.

For the screening test, an ELISA is done, as follows: the spirochete Borrelia burgdorferi, the causative organism of Lyme disease, is grown in culture and fixed to a microscope slide. The slide is then incubated with a sample of serum (the portion of blood that contains antibodies) from you. A fluorescent-labeled antiglobulin is placed on the slide and viewed under ultraviolet light. If human antibody to Lyme disease is present, it will bind to the fluorescent antiglobulin and be visible under the ultraviolet light.

A more specific test is a Western blot, where the specific antigen bands for Lyme disease are analyzed. This test is the true confirmation of Lyme disease.



How to prepare for the test:
Adult:
There is no special preparation for the test.

Infants and children:
The physical and psychological preparation you can provide for this or any test or procedure depends on your child's age, interests, previous experiences, and level of trust. For specific information regarding how you can prepare your child, see the following topics as they correspond to your child's age:

How the test will feel:
When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing.

Why the test is performed:
The test is performed to help confirm the diagnosis of Lyme disease.

Normal Values:
Nonreactive or a very low serum titer can be normal.

What abnormal results mean:
A titer of 1:128 is borderline and further testing is indicated. A positive serology by ELISA can help confirm the diagnosis of Lyme disease, but it is not definitive. Other diseases and high rheumatoid factors can cause false positives. A Western blot can confirm the diagnosis of Lyme disease.

What the risks are:
  • Excessive bleeding
  • Fainting or feeling light-headed
  • Hematoma (blood accumulating under the skin)
  • Infection (a slight risk any time the skin is broken)
  • Multiple punctures to locate veins


Special considerations:
Veins and arteries vary in size from one patient to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others.


Review Date: 1/6/2002
Reviewed By: Camille Kotton, M.D., Infectious Diseases Division, Massachusetts General Hospital and Brigham and Women's Hospital, Boston, MA. Review provided by VeriMed Healthcare Network.

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