Name of the Procedure:

Antibody; Borrelia burgdorferi (Lyme disease) confirmatory test
Common name(s): Western Blot, Immunoblot

Summary

This test is used to confirm the presence of antibodies against Borrelia burgdorferi, the bacteria responsible for Lyme disease. It typically follows an initial screening test to provide a more definitive diagnosis.

Purpose

This procedure is performed to diagnose Lyme disease by detecting specific antibodies in the blood. The goal is to confirm an infection with Borrelia burgdorferi and enable appropriate treatment.

Indications

• Unexplained flu-like symptoms following a tick bite
• A characteristic rash known as erythema migrans
• Joint pain or swelling, particularly in the knees
• Neurological symptoms such as facial palsy, meningitis, or nerve pain
• Cardiovascular issues such as heart block

Preparation

• There are typically no special preparations required for this test.
• Patients should inform their healthcare provider of any medications or supplements they are taking.

Procedure Description

1. A blood sample is drawn from a vein, usually in the arm.
2. The sample is then processed in a lab to detect IgM and IgG antibodies against specific proteins of Borrelia burgdorferi.
3. The results are typically compared to known standards to confirm the presence of Lyme disease.

Duration

The blood draw takes approximately 5-10 minutes. Laboratory processing can take several days to a week.

Setting

The blood sample is usually collected in a hospital, outpatient clinic, or doctor's office, and then sent to a specialized laboratory for analysis.

Personnel

• The blood draw is performed by a phlebotomist or nurse.
• Laboratory technicians and medical technologists perform the antibody detection tests.

Risks and Complications

• Minor discomfort or bruising at the blood draw site
• Rarely, infection or excessive bleeding from the puncture site

Benefits

• Provides a confirmation of Lyme disease diagnosis following an initial positive screening test
• Helps in guiding appropriate treatment
• Can potentially prevent serious complications from untreated Lyme disease if diagnosed early

Recovery

• No special recovery is required after the blood draw.
• Patients may resume normal activities immediately after.

Alternatives

• Initial ELISA (Enzyme-Linked Immunosorbent Assay) test for screening
• Clinical diagnosis based on symptoms and history, in the absence of confirmatory testing
• PCR (Polymerase Chain Reaction) test on joint fluid or spinal fluid (less common)

Patient Experience

• Patients typically feel a small prick during the blood draw with minor discomfort.
• Post-procedure, they may have a small bruise or soreness at the puncture site that resolves quickly.
• Overall, it is a minimally invasive and straightforward test for confirming Lyme disease.