Serologic Tests for Lyme Disease: More Smoke and Mirrors

Prospective study of serologic tests for lyme disease.

BACKGROUND Tests to determine serum antibody levels-the 2-tier sonicate immunoglobulin M (IgM) and immunoglobulin G (IgG) enzyme-linked immunosorbent assay (ELISA) and Western blot method or the IgG of the variable major protein-like sequence-expressed (VlsE) sixth invariant region (C6) peptide ELISA method-are the major tests available for support of the diagnosis of Lyme disease. However, the...

Serologic Testing in Lyme Disease

Topic Overview: How should a clinician employ serologic tests in a Lyme disease evaluation? Before ordering an ELISA or Western blot the clinician should develop a clinical impression of the patient, taking into account the exposure history, symptoms and exam findings. If Lyme disease is judged to be a diagnostic possibility then testing is reasonable. Neither ELISA nor Western blot testing is ...

Immunodiagnostic tests for Lyme disease.

Standardized serologic tests for Lyme disease are needed, as isolation or in situ demonstration of the spirochete has proved difficult. At the Centers for Disease Control (CDC), an indirect immunofluorescence assay (IFA) was modified from a previously described IFA, and an enzyme-linked immunosorbent assay (ELISA) was developed with soluble spirochetal antigens. Both tests were evaluated with s...

Cross-reactivity of nonspecific treponemal antibody in serologic tests for Lyme disease.

Serum samples obtained from 59 persons who had acute necrotizing ulcerative gingivitis, periodontitis, syphilis, or Lyme disease were tested against Treponema phagedenis biotype Reiter, Treponema denticola, Treponema vincentii, and Treponema scoliodontum by indirect fluorescent-antibody staining methods. Although there were positive reactions for sera representing each of these study groups and...

Lyme disease: How reliable are serologic results?