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Antibody; Borrelia burgdorferi (Lyme disease)

CPT4 code

Name of the Procedure:

Antibody Test for Borrelia burgdorferi (Lyme Disease)

Summary

An antibody test for Borrelia burgdorferi checks for the presence of antibodies in the blood that the body produces in response to the bacteria that cause Lyme disease. It is a blood test usually done in two steps: an initial screening followed by a confirmatory test if the result is positive or inconclusive.

Purpose

The antibody test for Borrelia burgdorferi is used to diagnose Lyme disease, which is transmitted through the bite of infected black-legged ticks. The goal is to identify whether the immune system has responded to the infection, which helps in confirming a diagnosis of Lyme disease and planning appropriate treatment.

Indications

  • Symptoms suggestive of Lyme disease such as rash (erythema migrans), fever, chills, headache, fatigue, muscle and joint aches, and swollen lymph nodes.
  • History of tick bite.
  • Unexplained neurological symptoms like facial palsy.
  • Arthritis symptoms without clear cause, particularly knee pain and swelling.

Preparation

  • No special preparations, such as fasting, are typically required.
  • Inform your healthcare provider about any medications or supplements you are taking.
  • Prior diagnostic tests like ELISA (enzyme-linked immunosorbent assay) may be required as an initial screening measure.

Procedure Description

  1. A healthcare professional will draw a small amount of blood from a vein in your arm using a sterile needle.
  2. The blood sample is sent to a laboratory where the first test, usually an ELISA, is performed to detect antibodies against Borrelia burgdorferi.
  3. If the initial test is positive or inconclusive, a confirmatory Western Blot test is conducted to verify the results.
  4. The Western Blot involves separating proteins by gel electrophoresis and detecting Borrelia-specific bands using specific antibodies.

Duration

The blood draw itself typically takes less than 10 minutes. Lab processing of the tests might take a few days to a week depending on the healthcare facility.

Setting

Outpatient clinic, hospital, or laboratory.

Personnel

  • Phlebotomist or nurse to collect the blood sample.
  • Laboratory technician or medical technologist to process and analyze the blood sample.
  • Healthcare provider to interpret the test results.

Risks and Complications

  • Mild pain or discomfort at the needle insertion site.
  • Slight bruising or bleeding.
  • Rarely, infection at the puncture site.
  • False-positive or false-negative results necessitating further tests.

Benefits

  • Accurate diagnosis of Lyme disease, enabling timely and appropriate treatment.
  • Helps prevent complications such as chronic joint inflammation, neurological symptoms, and heart problems associated with untreated Lyme disease.

Recovery

  • Typically no recovery time is needed post blood draw.
  • Follow post-procedure instructions regarding any wound care if applicable.
  • Schedule follow-up appointments as advised by your healthcare provider to discuss results and treatment options.

Alternatives

  • Clinical diagnosis based on symptoms and medical history.
  • Polymerase chain reaction (PCR) tests to detect bacterial DNA.
  • Culture methods, though less commonly used due to low sensitivity.
  • Pros and cons: Antibody tests are widely available and non-invasive, but may produce false negatives if done too early in the infection when antibodies have not yet developed. PCR and culture provide more direct evidence of infection but are more complex and less routinely available.

Patient Experience

  • You might feel a mild pain or stinging when the needle is inserted, and slight discomfort at the puncture site.
  • Any anxiety or pain associated with the blood draw can be managed with relaxation techniques or discussing concerns with the healthcare provider.
  • After the procedure, you can typically resume normal activities immediately.

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