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When serum samples were tested for anti-Borrelia antibodies using eight commercially available ELISAs and five immunoblot assays, intertest agreement was only modest.

Current guidelines for diagnosing Lyme disease include a two-tier testing algorithm: an enzyme-linked immunosorbent assay (ELISA) for detecting anti-Borrelia antibodies, followed by immunoblot confirmation of positive ELISA results. Commercially available tests are based on sonicated whole-cell Borrelia antigens, recombinant antigens, or a mixture of the two.
To compare the performance of these assays, researchers in the Netherlands tested serum samples for anti-Borrelia antibodies using eight commercial ELISAs and five immunoblots (4 commercial, 1 investigator-made). The 89 samples were from 59 patients with suspected Lyme disease, 14 healthy controls, and 16 patients with syphilis or Mycoplasma pneumoniae infection — conditions associated with highly cross-reactive antibodies.
Of the 89 samples, 35 (39%) tested negative — and 16 (18%) tested positive — on all ELISAs. The remaining 38 (43%) tested positive on one to seven ELISAs. The proportion of samples with positive results on any one ELISA ranged from 34% to 59% for patients with suspected Lyme disease and from 0% to 38% for patients with cross-reactive antibodies. Samples from healthy controls almost always had negative ELISA results.
Thirty-one of the samples from patients with suspected Lyme disease were also tested with all immunoblots. Interblot agreement was low (IgG, 30%–84%; IgM, 0%–46%), and it was no higher for recombinant antigens than for whole-cell antigens. Some samples that tested negative on all ELISAs showed blot reactivity; some that tested positive on all ELISAs tested negative on all blots.
Comment: These findings are sobering and, unfortunately, do not facilitate diagnosis of Lyme disease. Clinicians should rely on a precise clinical determination of Lyme disease, interpreting serologic test results with great caution. Clearly, several possible ELISA/blot combinations do not work together very well. Furthermore, there are true Lyme cases with positive ELISA but negative blot results (depending on the test used), and even a few with negative ELISA but positive blot results.
— Thomas Glück, MD

Published in Journal Watch Infectious Diseases August 31, 2011

http://infectious-diseases.jwatch.org/cgi/content/full/2011/831/1

By Sara Ross, The Packet & Times

“If diagnosed (with Lyme dis-ease) right off the bat, it would have been two weeks of antibi-otics and everything would have been fine,” Raven said.

Instead, she faced two years of hell.

Shortly after the bite, the first symptom set in: fatigue.

“Before that I was a really, really active person. I walked the dog three times a day, played indoor soccer, mixed baseball,” Raven said. “I can’t do that any-more.”

Then the blackouts started.

“I could be walking from one room to the other and the next thing I know, I’m laying on the couch,” Raven said.

She couldn’t remember simple things and was unable to form full sentences.

She dry-heaved constantly

Read more here:

http://www.orilliapacket.com/ArticleDisplay.aspx?archive=true&e=2877130