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2086419 tn?1332530299

Could anyone please help me on lyme test results?

I did blood tests for lyme and coinfections through Quest Diagnostics on March 1st. I called my doctor to see if I could get my results seeing that my appointment isnt until april 16th..That was a no go..no info over the phone..so I downloaded the gazelle app to our phone to get the results through email..yea thats pretty cool:)

he is an llmd who I was referred to by the vermont lyme network and I had an appt with him feb 28th. I showed him pics of my rash and told him my symptoms and he ordered testing..I have another test for something april 4th which i think started with a c with a number I really cant remember..
No I havent been treated since being bit dec 1 here are the pics of my bite on photobucket http://s1125.photobucket.com/albums/l600/kathypease/Tick%20Bite%20on%20my%20leg/#!cpZZ2QQtppZZ16

Anyway I have the results and downloaded them and I still have no clue if I have anything because I have no clue how to read the report..lol

I called quest and they wont tell me anything they said i have to wait for my doctors appt..
but here is the part of the test i dont understand all the coinfections look negative..

Test Name In Range Out Of Range Reference Range Lab
interpreted as truly positive until verified as
such using a confirmatory assay (e.g., B.
burgdorferi Western Blot).
The screening test and/or Western Blot for B.
burgdorferi antibodies may be falsely negative
in early stages of Lyme disease, including the
period when erythema migrans is apparent.
LYME DISEASE ANTIBODIES QWA
(IGG, IGM) WESTERN BLOT
LYME DISEASE AB (IGG) WB NEGATIVE NEGATIVE
18 KD (IGG) BAND NON-REACTIVE
23 KD (IGG) BAND NON-REACTIVE
28 KD (IGG) BAND NON-REACTIVE
30 KD (IGG) BAND NON-REACTIVE
39 KD (IGG) BAND NON-REACTIVE
41 KD (IGG) BAND NON-REACTIVE
45 KD (IGG) BAND NON-REACTIVE
58 KD (IGG) BAND NON-REACTIVE
66 KD (IGG) BAND NON-REACTIVE
93 KD (IGG) BAND NON-REACTIVE
IgG western blots which have 5 (or more) of the
10 significant bands are considered positive for
specific antibody to B. burgdorferi. (Proceedings
of the 2nd Conf. on Lyme Disease, Dearborn, MI,
1994.)
LYME DISEASE AB (IGM) WB POSITIVE NEGATIVE
23 KD (IGM) BAND REACTIVE
39 KD (IGM) BAND REACTIVE
41 KD (IGM) BAND REACTIVE
Caution must be used in supporting a diagnosis of
B.burgdorferi infection when sera are Western blot
IgM positive and Western blot IgG negative after
the initial 4 week period from onset. Because the
likelihood of a false-positive test result is high
for these individuals, a positive IgM test alone
is not recommended for use in determining active
disease in persons with illness of longer than one
month duration.
IgM western blots which have 2 (or more) of the
3 significant bands are considered positive for
specific antibody to B. burgdorferi. (Proceedings
of the 2nd Conf. on Lyme Disease, Dearborn, MI,
1994.)
PERFORMING SITE:
AMD QUEST DIAGNOSTICS NICHOLS INSTITUTE CHANTILLY, 14225 NEWBROOK DRIVE, CHANTILLY, VA 20151-2228 Laboratory Director: KENNETH L. SISCO, MD, CLIA: 49D0221801
QWA QUEST DIAGNOSTICS WALLINGFORD-CL 0091, 3 STERLING DRIVE, WALLINGFORD, CT 06492 Laboratory Director: NEENA SINGH, MD, CLIA: 07D0093126
15 Responses
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1763947 tn?1334055319
Welcome to the group. The best and maybe the worst since it is not what you to hear, I can tell you is that you may not get a positive Lyme or co-infection tests. It took 12 years for one of my friends to get any kind of positive and it only took  2 years for another. If you were recently bitten, it is easier to find and treat and get cured. Sorry that I  couldn't do more but if you are seeing a real LLMD then he should know this and treat you based on your symptoms not on an positive or false negative result.
Hope all goes well.
Helpful - 0
1763947 tn?1334055319
BTW, I am from Williamstown, MA not too far from Vermont.
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2086419 tn?1332530299
Thank you mojogal :)
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Avatar universal
Welcome to MedHelp Lyme.

I agree with the above that this is not a do-it-yourself project in trying to interpret the test results.  The reason is that the tests are incomplete data:  they are not very accurate, but instead are clues that your doc will put together with your symptoms and history to come to an educated guess of a diagnosis.  It's not like the +/- pregnancy tests.  

The most important thing is to have a doc who understands how to read the tests in view of your symptoms and history.  It sounds like your doc fits in that category, which is excellent news.

As to the tests themselves, a Lyme doc will read them differently than a nonLyme doc will.  There appear to me (but I'm NOT medically trained) that there are indications of positivity:

IgM are the antibodies your body makes against the Lyme bacteria soon after infection.

IgG are the antibodies your body makes a while (months, perhaps, but there is not a hard and fast cut off date) after infection.  That you were known to be bitten in December sounds like a fairly recent infection to me, but I'm no doc, and Lyme isn't that predictable.  ANY positive result should be taken seriously.  

So did you have a positive result?  Yes, it looks like you did, since reactive means positive:

LYME DISEASE AB (IGM) WB
23 KD (IGM) BAND REACTIVE
39 KD (IGM) BAND REACTIVE
41 KD (IGM) BAND REACTIVE

WB means Western blot, which is the name of the test.  'Reactive' means positive.  That you are positive on bands 23, 39 and 41 would, from what I have read, indicate Lyme:

-- Band 23 -- indicates that Osp [outer surface protein] C is positive, and that is specific to Lyme, meaning that no other infection would produce a positive on that band.  The outer surface protein is a protein found on the outside of the Lyme bug.

-- Band 39 -- is a major protein of the Lyme bacteria's little whiplike tail (flagellin), and is also specific to Lyme.

-- Band 41 -- is evidence of a spiral-shaped bacteria infection, of which Lyme is only one.

The test says:  "IgM western blots which have 2 (or more) of the 3 significant bands are considered positive for specific antibody to B. burgdorferi. (Proceedings of the 2nd Conf. on Lyme Disease, Dearborn, MI,
1994.)"  

You appear to have at least two of the three reported bands, which to my uneducated eye points to a positive test.

The labs will not discuss results with you, because they are not licensed to practice medicine.  It is your doc who has to read the tests and examine you and talk with you to make a diagnosis.  The lab doesn't know who you are or what your symptoms are, and again:  these aren't +/- pregnancy tests.  This is medicine the old fashioned way, and there's no other way to do it.  

But again:  it's your doc who has to interpret these.  Let us know what you hear!  Best wishes --
Helpful - 0
Avatar universal
PS the C4A test is another measure of your immune system's reaction to a Lyme infection.  Your doc would not be running tests like this if s/he didn't know his/her way around Lyme.  This is good.    
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2086419 tn?1332530299
Thanks so very much for all the info JackieCalifornia.. its just I was not sure because someone said I needed five bands to be positive..This stuff is all so very confusing..Yes I am sure my doc knows what he is doing he told me he has lyme himself.

Thanks so very much
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Avatar universal
From all the research I have done on Western Blot, you have a positive IgM Western Blot.  Only 2 of those 3 bands beed to be reactive in order to be positive, and you have all 3.  Your IgG WB is definitely negative. I believe that you are consistent with the CDC surveillance criteria and should be a reportable case to the CDC.  That's a great thing as there should be no dispute over your results.

Knowing what I do about how this infection gets worse over time, I would call my doctor to ask to start antibiotics now, rather than giving the bugs yet another 3 1/2 weeks to grow. Given your tick bite, rash, and positive WB, I would think they'd be willing to phone in an Rx to your pharmacy.  (This is what my LLMDs office did.). Or at least convince them to squeeze you in sooner!
Helpful - 0
Avatar universal
Oh, and the 5 bands to be positive refers to the IgG WB.  The "official" belief is that after 30 days of symptoms your immune system will convert from making IgM antibodies to making IgG antibodies, and that without the requisite IgG antibodies, a positive IgM must be a false positive.

Infortunately, there are a whole lot of people with immune systems like me that didn't get this memo, and have failed to produce the required quantity and type of IgG bands.  It's a whole lot harder for us to get diagnosed because we're supposedly "negative", even when we show Lyme specific antibodies.  Sigh.  Just another part of the messy situation that is Lyme Disease.

It's great that you got tested early!
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2086419 tn?1332530299
Thank you Ricobord for all the info..I have been trying to read a lot about it but it seems to get so overwhelming and one site will say this and one site will say that so I get so confused.and as for the advice I am going to give them a call monday to see if I can get in sooner or a prescription..The first appointment took 2 months to get in..lol
But its worth a shot.  Thank you for everything :)
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Avatar universal
Yeah, immune systems didn't get the memo on how long they were supposed to keep manufacturing IgG and IgM antibodies.  Docs can get SO stuck in their ways and lose respect for Mama Nature.  Grrr.
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Avatar universal
You could call the doc and ask to be put on the call list in case of a cancellation.  My LLMD was so packed that it was impossible to get in without a cancellation opening up a slot.  Not to worry, your doc understands the urgency of it all.  You don't need anything else to get anxious about.  Deep breaths!  You're doing fine.
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Avatar universal
You are right about this being so very confusing.  Lots of moving parts, and hard to keep track of it all.  And having Lyme brain on top of it as I did just made it harder!  Hang in there.  You're doing fine.
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2086419 tn?1332530299
I will hang in there :)
I really appreciate all the help from all of you.You guys are awesome :)
Thanks so much :)
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Avatar universal
Yeah, me too!

I never made IgG. IgM happens in the first  2 or 3 weeks of infection and then those cells convert to IgG (latent infection).  This is how it's "supposed" to work.  My has been there for TEN YEARS and I only had IgM.

The problem with Lyme, is that it literally disrupts the mechanism for cells to go from IgM to IgG and most scientists are not used to seeing this. Lyme is essentially a new type of bacteria, not behaving as it should.

So with no IgG, the body is literally treating the infection as a *new* infection indefinitely.

Coupled with its ability to disrupt this process of IgM to IgG, it also changes it's proteins constantly and created biofilm over itself to hide from the immune system. It ALSO, creates cysts when blasted with antibiotics, hides in tissue (brain, joints) and has a divides very slowly (every six months) which is why it takes a LONG course of antibiotics to even weed some of them out. Basically our body sees them as a CONSTANT infection. Great.

ugh.. Lyme.
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Avatar universal
Good points.  

My doc prescribed not only antibiotics to kill the Lyme bacteria, but also another antibiotic, Flagyl, to break through the cyst formations so the other antibiotics could do their killing routine.

And about the slow reproductive process, I've read that too ... and it's also true of tuberculosis bacteria, which has a usual treatment time of 18 months minimum.  (We know someone whose kid got TB from a visitor from outside the US, and that's how long the treatment was for the kid:  18 months.)
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