Western Blotting in the Serodiagnosis of Lyme Disease

J Infect Dis. 1993 Feb;167(2):392-400. doi: 10.1093/infdis/167.2.392.

Abstract

There are currently no accepted criteria for positive Western blots in Lyme disease. In a retrospective analysis of 225 case and control subjects, the best discriminatory ability of test criteria was obtained by requiring at least 2 of the 8 most common IgM bands in early disease (18, 21, 28, 37, 41, 45, 58, and 93 kDa) and by requiring at least 5 of the 10 most frequent IgG bands after the first weeks of infection (18, 21, 28, 30, 39, 41, 45, 58, 66, and 93 kDa). When these definitions were tested in a prospective study of all 237 patients seen in a diagnostic Lyme disease clinic during a 1-year period and in 74 patients with erythema migrans or summer flu-like illnesses, the IgM blot in early disease had a sensitivity of 32% and a specificity of 100%; the IgG blot after the first weeks of infection had a sensitivity of 83% and a specificity of 95%. Among patients with indeterminate IgG responses by ELISA, 6 of 9 patients with active Lyme disease had positive blots compared with 2 of 34 patients with other illnesses (P < .001). Thus, Western blotting can be used to increase the specificity of serologic testing in Lyme disease.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Antibodies, Bacterial / blood*
  • Arthritis, Infectious / diagnosis
  • Blotting, Western*
  • Borrelia burgdorferi Group / immunology*
  • Brain Diseases / diagnosis
  • Enzyme-Linked Immunosorbent Assay
  • Erythema Chronicum Migrans / diagnosis
  • Humans
  • Immunoglobulin G / blood
  • Immunoglobulin M / blood
  • Lyme Disease / diagnosis*
  • Meningitis, Bacterial / diagnosis
  • Peripheral Nervous System Diseases / diagnosis
  • Prospective Studies
  • Retrospective Studies
  • Sensitivity and Specificity

Substances

  • Antibodies, Bacterial
  • Immunoglobulin G
  • Immunoglobulin M