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Really need help understanding / interpreting these results!
Hi guys!
Some time ago my girlfriend and I went to germany in order to get some tests done for lyme disease (its not really something that is offered here). However, we've a really hard time understanding the results from the tests!
I really hope some of you can help me here, since we're really struggling with this and where to go from here, and the situation is rapidly deteriorating
Thank you SO much.
Best,
Sune
----
Borrelia burgdorferi antibodies (ELISA)
Borrelia-IgG-antibodies (ELISA) 3.3 RU/ml
Borrelia-IgM-antibodies (ELISA) 9.2 RU/ml
Borrelia burgdorferi antibodies (immunoblot)
Borrelia-Blot-IgG-antibodies negative
Borrelia-Blot-IgM-antibodies negative
Borrelia burgdorferi Elispot LTT
Borrelia burgd. Fully Antigen + 9 SI
Borrelia OSP-Mix (OSPA/OSPC/DbpA) (+) 2 SI
Borrelia LFA-1 (+) 2 SI
Mycoplasma pneumoniae antibodies
Mycoplasma pneumoniae-IgG (EIA) (+) 0.9 Ratio
Mycoplasma pneumoniae-IgM (EIA) 0.8 Ratio
Mycoplasma pneumoniae IgA (EIA) 0.6 Ratio
Epstein-Barr-Virus antibodies
EBV-CA-IgG-antibodies (EIA) + 4.2 Ratio
EBV-EBNA-antibodies (EIA) + 2.8 Ratio
EBV-CA-IgM-antibodies (EIA) 0.1 Ratio
Epstein-Barr-Virus Elispot LTT
EBV-Elispot-LTT (lytic) + 4 SI
EBV-Elispot-LTT (latent) + 23 SI
CD 57 Flow Cytometry
Leucocytes 9.0 tsd/ul
Peripheral Lymphocytes 19.40 %
Lymphocytes 1746 /µl
Natural killer cells 7.99 %
Natural killer cells 140 /µl
CD 57 positive NK-cells - 1.45 %
CD 57 positive NK-cells - 25 /µl
----
Some time ago my girlfriend and I went to germany in order to get some tests done for lyme disease (its not really something that is offered here). However, we've a really hard time understanding the results from the tests!
I really hope some of you can help me here, since we're really struggling with this and where to go from here, and the situation is rapidly deteriorating
Thank you SO much.
Best,
Sune
----
Borrelia burgdorferi antibodies (ELISA)
Borrelia-IgG-antibodies (ELISA) 3.3 RU/ml
Borrelia-IgM-antibodies (ELISA) 9.2 RU/ml
Borrelia burgdorferi antibodies (immunoblot)
Borrelia-Blot-IgG-antibodies negative
Borrelia-Blot-IgM-antibodies negative
Borrelia burgdorferi Elispot LTT
Borrelia burgd. Fully Antigen + 9 SI
Borrelia OSP-Mix (OSPA/OSPC/DbpA) (+) 2 SI
Borrelia LFA-1 (+) 2 SI
Mycoplasma pneumoniae antibodies
Mycoplasma pneumoniae-IgG (EIA) (+) 0.9 Ratio
Mycoplasma pneumoniae-IgM (EIA) 0.8 Ratio
Mycoplasma pneumoniae IgA (EIA) 0.6 Ratio
Epstein-Barr-Virus antibodies
EBV-CA-IgG-antibodies (EIA) + 4.2 Ratio
EBV-EBNA-antibodies (EIA) + 2.8 Ratio
EBV-CA-IgM-antibodies (EIA) 0.1 Ratio
Epstein-Barr-Virus Elispot LTT
EBV-Elispot-LTT (lytic) + 4 SI
EBV-Elispot-LTT (latent) + 23 SI
CD 57 Flow Cytometry
Leucocytes 9.0 tsd/ul
Peripheral Lymphocytes 19.40 %
Lymphocytes 1746 /µl
Natural killer cells 7.99 %
Natural killer cells 140 /µl
CD 57 positive NK-cells - 1.45 %
CD 57 positive NK-cells - 25 /µl
----
Thank you to all of you for your help!
I've posted the Chlamydia pneumoniae results on http://www.cpnhelp.org/interpreting_results_elis if you're interested in following.
I've posted the Chlamydia pneumoniae results on http://www.cpnhelp.org/interpreting_results_elis if you're interested in following.
It's hard to tell what they meant about 'strong unspecific fluorescence' -- it could be something related to how the test functions ... or it could mean something malfunctioned in performing the test.
For example, if I took a photo with a flash bulb but the room wasn't dark enough to need flash, then the foto could be overexposed ... and a techie might describe the result as 'a strong unspecific fluorescence.' In other words, the test was messed up by too much light.
You could call the lab that ran the test ask them what that phrase means. Let us know what you find out..
For example, if I took a photo with a flash bulb but the room wasn't dark enough to need flash, then the foto could be overexposed ... and a techie might describe the result as 'a strong unspecific fluorescence.' In other words, the test was messed up by too much light.
You could call the lab that ran the test ask them what that phrase means. Let us know what you find out..
Hi Ricobord
Thank you for such a long and detailed reply!
I'm planning on posting the C. Pneumoniae results at http://www.cpnhelp.org/ to see if they have any experience interpreting the Ellispot results!
With the b. henselae titer results, if you notice the lab writes "No exact result because of a strong unspecific fluorescence in the background.". Do you interpret this as meaning that the results can't really be trusted?
Otherwise it definitely sounds like there is something there.
Unfortunately I don't know anything about the western blot, only that quote from wikipedia which indicates that immunoblot is the same.
Thank you for such a long and detailed reply!
I'm planning on posting the C. Pneumoniae results at http://www.cpnhelp.org/ to see if they have any experience interpreting the Ellispot results!
With the b. henselae titer results, if you notice the lab writes "No exact result because of a strong unspecific fluorescence in the background.". Do you interpret this as meaning that the results can't really be trusted?
Otherwise it definitely sounds like there is something there.
Unfortunately I don't know anything about the western blot, only that quote from wikipedia which indicates that immunoblot is the same.
I am not up to date with recent publications on CD57, but my general impression is that at least some Lyme docs had great hope that CD57 would be a good indicator of Lyme and a patient's progress through treatment. That was a few years ago, and the excitement seems to have dimmed since then, so that CD57 is still often interesting to a doc, but is not the 'yes/no, Lyme/not Lyme' binary indicator it was hoped to be.
Thank you for the comment mojogal! What you're saying is that if your CD57 is high it doesn't mean that you're not ill, but if its low then it is definitely an indicator that something is wrong?
Well, according to your lab report, you should be concerned about Borrelia, Bartonella, Chlamydia Pneumoniae, and Epstein Barr. Plenty of people don't show enough antibodies on a blood test, which is why some pioneers are developing other tests, such as the Ellispot, to look for other indicators.
Not much you can do about Epstein Barr, but the others are treatable. EBV seems to flare up in people who are immune suppressed, adding in more fatigue and malaise to the mix. (Both Borrelia and Bartonella suppress the immune system.)
My C. Pneumoniae IgG was a bit high like yours, but I was told mine was still okay. You have a 2nd test, an Ellispot, that shows a much higher result. I wonder if I should get that one done. I'm not sure if the Ellispot is available in the U.S.
My b. henselae titer (antibody measurement) was only 1:80 (an IgeneX "Not Negative" result) and I had/have Bartonella. Yours is greater than 1:320, more than 4 times mine. At IGeneX, they call 1:160 a full positive. We treated it for 5 months and thought it was gone. Now, 15 months later, we've resumed treatment again as it seems it was hiding there all along. Again, antibody levels are a poor measurement of level of illness. Often times, high antibody results indicate a strong immune response. This doesn't mean you're sicker. It could actually mean the infection is on the run and the immune system is winning.
If the immunoblot was the same as a Western Blot, wouldn't they have showed individual bands?
Not much you can do about Epstein Barr, but the others are treatable. EBV seems to flare up in people who are immune suppressed, adding in more fatigue and malaise to the mix. (Both Borrelia and Bartonella suppress the immune system.)
My C. Pneumoniae IgG was a bit high like yours, but I was told mine was still okay. You have a 2nd test, an Ellispot, that shows a much higher result. I wonder if I should get that one done. I'm not sure if the Ellispot is available in the U.S.
My b. henselae titer (antibody measurement) was only 1:80 (an IgeneX "Not Negative" result) and I had/have Bartonella. Yours is greater than 1:320, more than 4 times mine. At IGeneX, they call 1:160 a full positive. We treated it for 5 months and thought it was gone. Now, 15 months later, we've resumed treatment again as it seems it was hiding there all along. Again, antibody levels are a poor measurement of level of illness. Often times, high antibody results indicate a strong immune response. This doesn't mean you're sicker. It could actually mean the infection is on the run and the immune system is winning.
If the immunoblot was the same as a Western Blot, wouldn't they have showed individual bands?
Your lab results are something I have never seen so I wouldn't want to take a guess however the CD-57 in the US, use to be highly regarded but is not so much anymore. My CD-57 is very low which makes sense because I am still actively ill. I have heard of other people who are sick but there CD-57 are not low. Thus that causes a problem of the reliability of the test.
Hi Ricobord!
According to wikipedia: "The western blot (sometimes called the protein immunoblot) is a widely accepted analytical technique used to detect specific proteins in the given sample of tissue homogenate or extract." - So I'm guessing that Western Blot and Immunoblot is the same thing?
You completely right! I don't know how the ranges didn't get in there when I pasted it, but I've put them in the results below, as well as results for the Chlamydia Pneumoniae which we also got. Also I found some additional indications from the laboratory that performed the tests.
To be honest I find it really hard to understand them - Some of them are within the normal ranges and some of them are out of the normal ranges and it just seems like contradictions? (at least when I don't understand what the individual values mean!)
----
Borrelia burgdorferi antibodies (ELISA)
Borrelia-IgG-antibodies (ELISA) 3.3 RU/ml 22.0=pos.
Borrelia-IgM-antibodies (ELISA) 9.2 RU/ml 22.0=pos.
Borrelia burgdorferi antibodies (immunoblot)
Borrelia-Blot-IgG-antibodies negative negative
Borrelia-Blot-IgM-antibodies negative negative
The specific Borrelia burgdorferi-IgG/IgM-antibodies are no indication for a humoral immune-response against Borrelia burgdorferi. Please look at the results of the Borrelia-Elispot-LTT and the CD57+cell-count. Please take into consideration the clinical symptoms and the differential diagnosis (co-infections).
Borrelia burgdorferi Elispot LTT
Borrelia burgd. Fully Antigen + 9 SI < 2
Borrelia OSP-Mix (OSPA/OSPC/DbpA) (+) 2 SI < 2
Borrelia LFA-1 (+) 2 SI < 2
The results of the Elispot-Lymphocyte-Transformation-Tests are an indication for an actual cellular activity against Borrelia burgdorferi.
Explanation Elispot-LTT (LymphocyteTransformationTest):
This method detects an antigen (Borrelia, Chlamydia, Ehrlichia, EBV, Yersinia) induced release of interferon gamma by reactive lymphocytes. In the Elispot-LTT the Tlymphocytes are stimulated by bacterial or viral antigens. Antigen specific release of IFN gamma is detected by a standardized ELISA colour technique in form of “spots”. The number of spots is resulted in form of a stimulation-index (SI) in comparison with a negative control (reference range: 2 SI (positive) mean a specific response of the Tlymphocytes regarding the different antigens in the Elispot-LTT. The higher the result of the SI, the stronger is the T-cellular immune-response in general.
Chlamydia pneumoniae antibodies
Chlam.pneum.-IgG-antibodies (ELISA)+ 1.2 Ratio 1.1=pos.
Chlam.pneum.-IgA-antibodies (ELISA)+ 1.2 Ratio 1.1=pos.
The specific Chlamydia pneumoniae-IgG- and -IgA-antibodies are an indication for an actual humoral immune response against Chlamydia pneumoniae. Please look at the Chlamydia-Elispot-LTT for the actual cellular activity.
Chlamydia pneumoniae Elispot LTT
Chlamydia pneumoniae-Elispot LTT + 30 SI < 2
The result of the Elispot-Lymphocyte-Transformation-Test (LTT) is an indication for an actual cellular activity against Clamydia pneumoniae.
Mycoplasma pneumoniae antibodies
Mycoplasma pneumoniae-IgG (EIA) (+) 0.9 Ratio 1.1 = pos.
Mycoplasma pneumoniae-IgM (EIA) 0.8 Ratio 1.1 = pos.
Mycoplasma pneumoniae IgA (EIA) 0.6 Ratio 1.1 = pos.
The specific M. pneumoniae-IgG-antibodies are an indication for a borderline humoral immune response against Mycoplasma pneumoniae.
Bartonella antibodies
Bartonella henselae-IgG-IFT (+) 1:320 Titer < 1:320 No exact result because of a strong unspecific fluorescence in the background.
Bartonella quintana-IgG-IFT < 1:320 Titer < 1:320
Serological borderline evidence for an infection with Bartonella henselae. We recommend a serological control of Bartonella henselae-IgG and IgM antibodies in 3-4 weeks and the Bartonella-DNS in blood by PCR technique.
Epstein-Barr-Virus antibodies
EBV-CA-IgG-antibodies (EIA) + 4.2 Ratio 1.1=pos
EBV-EBNA-antibodies (EIA) + 2.8 Ratio 1.1=pos
EBV-CA-IgM-antibodies (EIA) 0.1 Ratio 1.1=pos
The specific EBV-Virus-IgG- and EBV-EBNA-antibodies are an indication for a humoral immune-response against Epstein-Barr-Virus.
Please look at the result of the actual T-cellular EBV-acitivity by EBV-Elispot-LTT.
Epstein-Barr-Virus Elispot LTT
EBV-Elispot-LTT (lytic) + 4 SI < 2
EBV-Elispot-LTT (latent) + 23 SI < 2
The results of the EBV-Elispot-Lymphocyte-Transformation-Tests are an indication for an actual cellular activity against Epstein-Barr-Virus.
Positive reactions in the EBV-Elispot-LTT can be a sign for an actual active EBVinfection.
We recommend a control of the EBV-Elispot-LTT and the EBV-antibodies in 3-4 weeks.
CD 57 Flow Cytometry
Leucocytes 9.0 tsd/ul 4-10
Peripheral Lymphocytes 19.40 % 18.0-51.0
Lymphocytes 1746 /µl 468-5100
Natural killer cells 7.99 % 6-29
Natural killer cells 140 /µl 60-700
CD 57 positive NK-cells - 1.45 % 2-77
CD 57 positive NK-cells - 25 /µl 100-360
The CD57-cell-count is an indication for a chronic immune-suppressive situation caused by Borrelia burgdorferi.
According to wikipedia: "The western blot (sometimes called the protein immunoblot) is a widely accepted analytical technique used to detect specific proteins in the given sample of tissue homogenate or extract." - So I'm guessing that Western Blot and Immunoblot is the same thing?
You completely right! I don't know how the ranges didn't get in there when I pasted it, but I've put them in the results below, as well as results for the Chlamydia Pneumoniae which we also got. Also I found some additional indications from the laboratory that performed the tests.
To be honest I find it really hard to understand them - Some of them are within the normal ranges and some of them are out of the normal ranges and it just seems like contradictions? (at least when I don't understand what the individual values mean!)
----
Borrelia burgdorferi antibodies (ELISA)
Borrelia-IgG-antibodies (ELISA) 3.3 RU/ml 22.0=pos.
Borrelia-IgM-antibodies (ELISA) 9.2 RU/ml 22.0=pos.
Borrelia burgdorferi antibodies (immunoblot)
Borrelia-Blot-IgG-antibodies negative negative
Borrelia-Blot-IgM-antibodies negative negative
The specific Borrelia burgdorferi-IgG/IgM-antibodies are no indication for a humoral immune-response against Borrelia burgdorferi. Please look at the results of the Borrelia-Elispot-LTT and the CD57+cell-count. Please take into consideration the clinical symptoms and the differential diagnosis (co-infections).
Borrelia burgdorferi Elispot LTT
Borrelia burgd. Fully Antigen + 9 SI < 2
Borrelia OSP-Mix (OSPA/OSPC/DbpA) (+) 2 SI < 2
Borrelia LFA-1 (+) 2 SI < 2
The results of the Elispot-Lymphocyte-Transformation-Tests are an indication for an actual cellular activity against Borrelia burgdorferi.
Explanation Elispot-LTT (LymphocyteTransformationTest):
This method detects an antigen (Borrelia, Chlamydia, Ehrlichia, EBV, Yersinia) induced release of interferon gamma by reactive lymphocytes. In the Elispot-LTT the Tlymphocytes are stimulated by bacterial or viral antigens. Antigen specific release of IFN gamma is detected by a standardized ELISA colour technique in form of “spots”. The number of spots is resulted in form of a stimulation-index (SI) in comparison with a negative control (reference range: 2 SI (positive) mean a specific response of the Tlymphocytes regarding the different antigens in the Elispot-LTT. The higher the result of the SI, the stronger is the T-cellular immune-response in general.
Chlamydia pneumoniae antibodies
Chlam.pneum.-IgG-antibodies (ELISA)+ 1.2 Ratio 1.1=pos.
Chlam.pneum.-IgA-antibodies (ELISA)+ 1.2 Ratio 1.1=pos.
The specific Chlamydia pneumoniae-IgG- and -IgA-antibodies are an indication for an actual humoral immune response against Chlamydia pneumoniae. Please look at the Chlamydia-Elispot-LTT for the actual cellular activity.
Chlamydia pneumoniae Elispot LTT
Chlamydia pneumoniae-Elispot LTT + 30 SI < 2
The result of the Elispot-Lymphocyte-Transformation-Test (LTT) is an indication for an actual cellular activity against Clamydia pneumoniae.
Mycoplasma pneumoniae antibodies
Mycoplasma pneumoniae-IgG (EIA) (+) 0.9 Ratio 1.1 = pos.
Mycoplasma pneumoniae-IgM (EIA) 0.8 Ratio 1.1 = pos.
Mycoplasma pneumoniae IgA (EIA) 0.6 Ratio 1.1 = pos.
The specific M. pneumoniae-IgG-antibodies are an indication for a borderline humoral immune response against Mycoplasma pneumoniae.
Bartonella antibodies
Bartonella henselae-IgG-IFT (+) 1:320 Titer < 1:320 No exact result because of a strong unspecific fluorescence in the background.
Bartonella quintana-IgG-IFT < 1:320 Titer < 1:320
Serological borderline evidence for an infection with Bartonella henselae. We recommend a serological control of Bartonella henselae-IgG and IgM antibodies in 3-4 weeks and the Bartonella-DNS in blood by PCR technique.
Epstein-Barr-Virus antibodies
EBV-CA-IgG-antibodies (EIA) + 4.2 Ratio 1.1=pos
EBV-EBNA-antibodies (EIA) + 2.8 Ratio 1.1=pos
EBV-CA-IgM-antibodies (EIA) 0.1 Ratio 1.1=pos
The specific EBV-Virus-IgG- and EBV-EBNA-antibodies are an indication for a humoral immune-response against Epstein-Barr-Virus.
Please look at the result of the actual T-cellular EBV-acitivity by EBV-Elispot-LTT.
Epstein-Barr-Virus Elispot LTT
EBV-Elispot-LTT (lytic) + 4 SI < 2
EBV-Elispot-LTT (latent) + 23 SI < 2
The results of the EBV-Elispot-Lymphocyte-Transformation-Tests are an indication for an actual cellular activity against Epstein-Barr-Virus.
Positive reactions in the EBV-Elispot-LTT can be a sign for an actual active EBVinfection.
We recommend a control of the EBV-Elispot-LTT and the EBV-antibodies in 3-4 weeks.
CD 57 Flow Cytometry
Leucocytes 9.0 tsd/ul 4-10
Peripheral Lymphocytes 19.40 % 18.0-51.0
Lymphocytes 1746 /µl 468-5100
Natural killer cells 7.99 % 6-29
Natural killer cells 140 /µl 60-700
CD 57 positive NK-cells - 1.45 % 2-77
CD 57 positive NK-cells - 25 /µl 100-360
The CD57-cell-count is an indication for a chronic immune-suppressive situation caused by Borrelia burgdorferi.
I know the labs in Germany run some different tests than we get here. I am familiar with the bands on a Western Blot, but I don't think I can be of much help for you on this.
I do encourage you to look at the results again. Here in the U.S., labs usually offer a "reference range", which is a range that is considered "normal." Or, they offer a "positive" or "negative" result, which may or may not be meaningful.
For example, a lab told me I was "High" on my IgG for Chlamydia Pneumoniae, but my Physician's Assistant told me that it wasn't significant.
She said they'd need to see 3-5 times my levels before they'd be concerned about it.
Most importantly, you need a conversation with someone at the clinic that ordered the tests. You need to hear their take on the results. If you have to wait for that conversation and the wait is driving you crazy, then you could check the website of the lab that did the tests and see if they report what a "normal" or "negative" result is for the tests you took.
It does look like your CD57 (25) is low.
Did they not run a Western Blot? (I'm not familiar with the Immunoblot.)
I do encourage you to look at the results again. Here in the U.S., labs usually offer a "reference range", which is a range that is considered "normal." Or, they offer a "positive" or "negative" result, which may or may not be meaningful.
For example, a lab told me I was "High" on my IgG for Chlamydia Pneumoniae, but my Physician's Assistant told me that it wasn't significant.
She said they'd need to see 3-5 times my levels before they'd be concerned about it.
Most importantly, you need a conversation with someone at the clinic that ordered the tests. You need to hear their take on the results. If you have to wait for that conversation and the wait is driving you crazy, then you could check the website of the lab that did the tests and see if they report what a "normal" or "negative" result is for the tests you took.
It does look like your CD57 (25) is low.
Did they not run a Western Blot? (I'm not familiar with the Immunoblot.)
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