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Immunoblot (Line blot) - IgM

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Accredited by the Standards Council of Canada to Laboratory no. 594 (ISO/IEC 17025)

Requisition Forms

Reference Details

Description:

Detection of IgM antibodies to purified recombinant proteins p39 and p41, in addition to a dimeric p25 (OspC) and VlsE of Borrelia by immunoblot assay.

Test Category:
Serology
Pathogen:
Borrelia burgdorferi sensu stricto
Laboratory:
Illnesses and Diseases:
  • North American Lyme Disease
Specimen:

Fresh human serum.

Minimum volume required is 0.25 mL.

Hemolytic, lipemic or icteric sera may yield erroneous results.

Specimen should be collected during the acute phase (0-4 weeks) of onset of symptoms.  

Collection Method:

Collect blood in serum separator tubes.

Specimen Processing, Storage and Shipping:

Transfer an aliquot of serum to a 1.5 ml screw-top vial with O-ring (Sarstedt vial). Store specimens refrigerated up to 5 days or store frozen until shipped for testing. Ship frozen on dry ice or with freezer packs.

Transportation of Dangerous Goods:

Shipping of specimens shall be done by a TDG certified individual in accordance with TDG regulations. For additional information regarding classification of specimens for the purposes of shipping, consult either Part 2 Appendix 3 of the TDG Regulations or section 3.6.2 of the IATA Dangerous Goods Regulations as applicable.

 

Patient Criteria:

Appropriate clinical symptoms with potential exposure to blacklegged ticks. Typical symptoms include fever, headache, fatigue, and a characteristic rash may be present. If left untreated, infection can spread to joints, the heart, and the nervous system.

The IgM immunoblot is intended only for human sera which have been found positive or equivocal on the Lyme disease screening assay (e.g. ELISA) and are negative by IgG immunoblot.

Accompanying Documentation:

Completed Requisition for Serological Testing for Selected Zoonotic Agents. If possible, include the clinical history and lab results performed at local or provincial laboratories.

Comments:

Specimens may be subject to rejection if they are not the appropriate sample type, have insufficient volume, or are not accompanied by relevant patient information.

The IgM immunoblot test will not be performed on serum samples that were collected >6 weeks post onset of symptoms or were positive by the IgG immunoblot.

Please contact the laboratory if a re-infection is suspected.

Methods and Interpretation of Results:

Commercial immunoblot assay. This is a qualitative test for the detection of IgM antibodies to individual proteins of Borrelia. 

Caution must be used in supporting a diagnosis of B. burgdorferi infection if a sample is positive by IgM immunoblot and negative by IgG immunoblot after the initial 4-6 week period from onset of symptoms. 

If symptoms persist, a convalescent specimen should be submitted after an additional 3 to 6 weeks to test for seroconversion to IgG antibodies.

Initiation of antibiotic treatment prior to testing may result in decreased antibody production which will affect the outcome of serological testing. However, if Lyme disease is suspected based on clinical symptoms, treatment should be initiated.

Turnaround Time:

21 calendar days.

Contact:
Phone #: (204) 789-6068
Fax: (204) 789-2082
References:
  1. Moore A, Nelson C, Molins C, Mead P, & Schriefer M. 2016. Current Guidelines, Common Clinical Pitfalls, and Future Directions for Laboratory Diagnosis of Lyme Disease, United States. Emerging Infectious Diseases 22(7): 1169-1177.
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