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Do these results look like Lyme?

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Posted 8/27/2015 5:21 PM (GMT 0)
Hi,

Can you please help with my test results? Here is some background as to why the tests were ordered.

I had a strange rash appear and my doctors couldn't figure out what caused it. It has the look of a bullseye rash, but there is no center to the bullseye (just an outer ring), and it literally appeared overnight. After a few weeks, it is now starting to fade. The 3rd doctor that I went to decided to do a Lyme's test. Here are the results:

IGG P93 AB. Absent
IGG P66 AB. Absent
IGG P58 AB. Absent
IGG P45 AB. Absent
IGG P41 AB. Present A
IGG P39 AB. Absent
IGG P30 AB. Absent
IGG P28 AB. Absent
IGG P23 AB. Absent
IGG P18 AB. Absent

LYME IGG WB INTERP. Negative
Positive: 5 of the following
Borrelia-specific bands:
18,23,28,30,39,41,45,58,
66, and 93.
Negative: No bands or banding
patterns which do not
meet positive criteria.

IGM P41 AB. Present A
IGM P39 AB. Absent
IGM P23 AB. Present A

LYME IGG WB INTERP. Positive A
Note: An equivocal or positive EIA result followed by a negative
Western Blot result is considered NEGATIVE. An equivocal or positive
EIA result followed by a positive Western Blot is considered POSITIVE
by the CDC.
Positive: 2 of the following bands: 23,39 or 41
Negative: No bands or banding patterns which do not meet positive
criteria.
Criteria for positivity are those recommended by CDC/ASTPHLD.
p23=Osp C, p41=flagellin
Note:
Sera from individuals with the following may cross react in the
Lyme Western Blot assays: other spirochetal diseases (periodontal
disease, leptospirosis, relapsing fever, yaws, and pinta);
connective autoimmune (Rheumatoid Arthritis and Systemic Lupus
Erythematosus and also individuals with Antinuclear Antibody);
other infections (Rocky Mountain Spotted Fever; Epstein-Barr Virus,
and Cytomegalovirus).

Also, over the last year, I have have been seeing a rheumy because of signs of Sjogren's Syndrome. I haven't been officially diagnosed, but I do have some of the ssb antibodies associated with Sjogrens. Based on that last note in the results, could this autoimmune disorder be skewing the Lyme results (giving a false positive)?

Thanks for your help!
Posted 8/27/2015 5:22 PM (GMT 0)
Sorry, I'm confused by this test. Are these your results or is this explaining the test?

Positive: 5 of the following
Borrelia-specific bands:
18,23,28,30,39,41,45,58,
66, and 93.

 

Posted 8/27/2015 5:27 PM (GMT 0)
Those are notes from the test. I just copied and pasted right from the lab results. Sorry, that it is so much material. But, if you note this part of the results:

LYME IGG WB INTERP. Negative- it then gave the explanation that positive would be 5 of the specific bands; which I didn't have, so it gave me a negative.

But, then further the test shows:

LYME IGG WB INTERP. Positive A - and it gave me the explanation that positive would be 2 of the following bands: 23,39 or 41 (which I do have), so it gave me a postive.
Posted 8/27/2015 5:31 PM (GMT 0)
I'm still a little confused. The neuro-lyme makes it hard to read all that text. So these are your results?

IGG WB:
IGG P93 AB. Absent
IGG P66 AB. Absent
IGG P58 AB. Absent
IGG P45 AB. Absent
IGG P41 AB. Present A
IGG P39 AB. Absent
IGG P30 AB. Absent
IGG P28 AB. Absent
IGG P23 AB. Absent
IGG P18 AB. Absent

IGM WB:
IGM P41 AB. Present A
IGM P39 AB. Absent
IGM P23 AB. Present A

If I'm reading this correctly, yes you need to see a LLMD. This is Lyme.

Here is an explanation of the bands. Band 23 is Lyme specific.

http://lymetwistontherocks.blogspot.com/2011/01/western-blots-what-do-all-of-those-darn.html

 

Posted 8/27/2015 5:31 PM (GMT 0)
Your igM is positive - I think perhaps there is a typo after the IgM results - "LYME IGG WB INTERP. Positive A"
I believe that should say IGM? As it follows the IgM band results.

Sarah - it is both her results and the interpretation of the results - what's required for a positive.
Posted 8/27/2015 5:32 PM (GMT 0)
What lab did you use? I'm going to assume that present is what we are used to seeing as indicative which means it's not all the way to positive but it's reacting. The only way that happens is if your body is creating antibodies for these lyme specific bands. It shows IGM 41 and 23 as Present.

There is no such thing as a false positive Lyme test. Most of us have used Igenex for our testing.

You have Lyme. Have you seen a LLMD (Lyme Literate MD)?
Posted 8/27/2015 5:33 PM (GMT 0)
Present means positive, jrpsf.

Girlie I edited my post. We posted at the same time.

Posted 8/27/2015 5:35 PM (GMT 0)
No - not a false positive.

Lyme can cause autoimmunity...it may be responsible for your sjogrens' symptoms and lab results.
Posted 8/27/2015 5:37 PM (GMT 0)
Thank you for your replies :-)

This was done at LabCorp. There was another test done at the same time that was called "Lyme Antibody Screen with Relfex." That test gave a result of "high" for LYMES ANTIBODY, IGM, IFA. Then, the test results that I posted above were for "Lyme, Western Blot, Serum."
Posted 8/27/2015 5:39 PM (GMT 0)
On those test results, I believe it's either Absent or Present - so Present = positive.

But, looks like the lab (if it is indeed copied and pasted) - has a typo - because it's saying IGG Positive, right under the IGM showing positive with band 41 and 23...
...or am I missing something?




IGM P41 AB. Present A
IGM P39 AB. Absent
IGM P23 AB. Present A

LYME IGG WB INTERP. Positive A

It should read LYME IGM WB INTERP. Positive A - should it not?
Posted 8/27/2015 5:40 PM (GMT 0)
No, I haven't seen a LLMD yet. My results were actually posted online by the medical provider (through their website), but I haven't spoken to the doctor yet. I've called in, but they said that she is in surgery all day today. So, I am waiting to hear back. This doctor is actually a breast surgeon (that is where my rash appeared), and I'm not sure that she is the best person for me to see regarding treatment. I definitely need to find a LLMD.
Posted 8/27/2015 5:42 PM (GMT 0)
Yes Girlie you're absolutely right. It's a positive IGM western blot since the results say both 23 and 41 are present.
Posted 8/27/2015 5:43 PM (GMT 0)
Yes, I thought that was confusing too. I think it should say "LYME IGM WB INTERP - Positive A" because it follows the IGM results, and not "LYME IGG WB INTERP. Positive A."
Posted 8/27/2015 5:45 PM (GMT 0)
So, if you just copied and pasted - then the lab made the mistake... nono


Well, I'm glad we got that sorted out...lol
Posted 8/27/2015 6:32 PM (GMT 0)
Another reason not to use LabCorp! :)
Posted 8/28/2015 8:26 PM (GMT 0)
This is the email that I just received from my doctor:

"My understanding of the results is that they are not specific for Lyme disease unless you have 5 positive markers, and you had 3 positive markers."

After the research I've done in the past few days, and reading here, I don't think that is correct. I guess I need to contact a LLMD.
Posted 8/28/2015 9:01 PM (GMT 0)
The doctor is sort of correct.
The current CDC criteria (used by the IDSA and health insurance companies) for a positive Western Blot are as follows:

(a) For IgM, 2 of the following three bands have to be positive: OspC
(22-25), 39 and 41.
(b) For IgG, 5 of the following ten bands have to be positive: 18, OspC
(22-25), 28, 30, 39, 41, 45, 58, 66 and 93.

Honestly for a non Lyme Dr to know that much is impressive. You do need 5 positive markers to have an IGG positive and only two positive markers for an IGM positive test.

An LLMD or ND is necessary.
Posted 8/28/2015 9:11 PM (GMT 0)
But, she has 23 and 41 'present' on the IgM - making it positive...so it should be CDC positive, as well - according to what it says on my Igenex test sheet. (2 of the bands: 23-25, 39, 41)
Posted 8/28/2015 9:56 PM (GMT 0)
Agreed Girlie. Since we had already covered that I was just explaining why the doctor who ordered the test for her would give that response.
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