Post by nyxie63 on Jan 6, 2009 7:43:46 GMT -8
Did a brief search here and on LNE and couldn't find this posted already so here it is. Unfortunately, this isn't the original article which includes tables. The original copy of the article (BJBS) is in a membership-only site.
findarticles.com/p/articles/mi_qa3874/is_200607/ai_n17183134
Potentially misleading Western blot results in Lyme disease diagnosis
British Journal of Biomedical Science, 2006 by Mavin, S, Evans, R, Appleyard, K, Joss, A W L, Ho-Yen, D
The laboratory diagnosis of Lyme disease is complex1 and serology remains the technique of choice. Recommended practice is a two-step process involving a sensitive screening enzyme immunoassay (EIA) followed by a more specific confirmatory Western blot for all EIA-positive and equivocal samples and for EIA-negative samples with a high clinical suspicion of Lyme disease (e.g., tick bite and erythema migrans).1,2 However, Western blot results require careful interpretation.
The National Lyme Disease Testing Service Laboratory, Raigmore Hospital, Inverness, tests over 3000 samples annually from across Scotland, many of which are from complex clinical cases. It was noted recently that serum from a patient with confirmed parvovirus B19 infection crossreacted with the in-house Borrelia burgdorferi IgG Western blot. This could lead to the wrong interpretation of Western blot results. This study aims to discover if other viral infections produce similar results with the B. burgdorferi IgG Western blot.
The study group consisted of six patients found to contain IgM antibodies to parvovirus B19 infection (parvovirus B19 IgM EIA, Biotrin International), six with cytomegalovirus (CMV) IgM (CMV IgM EIA, Microgen Bioproducts) and six with Epstein-Barr virus (EBV) IgM (EBV VCA IgM EIA, Diasorin). All patients had good clinical evidence of viral infection (Table 1).
The 18 serum samples were analysed by commercial B. burgdorferi IgG/IgM EIA (Zeus Scientific, New Jersey, USA) and an in-house B. burgdorferi IgG Western blot. The EIA was performed according to the manufacturer's instructions and the Western blot was performed as described previously.2
The blots used contained sodium dodecyl sulphate-extracted B. burgdorferi (i.e., antigen). A commercial positive control (Zeus Scientific) and in-house positive control, with defined band patterns, were included in each blot run. The number, intensity and molecular weight of bands observed with each sample were recorded, and a negative, equivocal, weak positive or positive result assigned according to predetermined criteria.3 The Western blot was repeated for all samples.
Previous or subsequent serum samples from five patients (serum samples 5,8. 9,11 and 12
findarticles.com/p/articles/mi_qa3874/is_200607/ai_n17183134
Potentially misleading Western blot results in Lyme disease diagnosis
British Journal of Biomedical Science, 2006 by Mavin, S, Evans, R, Appleyard, K, Joss, A W L, Ho-Yen, D
The laboratory diagnosis of Lyme disease is complex1 and serology remains the technique of choice. Recommended practice is a two-step process involving a sensitive screening enzyme immunoassay (EIA) followed by a more specific confirmatory Western blot for all EIA-positive and equivocal samples and for EIA-negative samples with a high clinical suspicion of Lyme disease (e.g., tick bite and erythema migrans).1,2 However, Western blot results require careful interpretation.
The National Lyme Disease Testing Service Laboratory, Raigmore Hospital, Inverness, tests over 3000 samples annually from across Scotland, many of which are from complex clinical cases. It was noted recently that serum from a patient with confirmed parvovirus B19 infection crossreacted with the in-house Borrelia burgdorferi IgG Western blot. This could lead to the wrong interpretation of Western blot results. This study aims to discover if other viral infections produce similar results with the B. burgdorferi IgG Western blot.
The study group consisted of six patients found to contain IgM antibodies to parvovirus B19 infection (parvovirus B19 IgM EIA, Biotrin International), six with cytomegalovirus (CMV) IgM (CMV IgM EIA, Microgen Bioproducts) and six with Epstein-Barr virus (EBV) IgM (EBV VCA IgM EIA, Diasorin). All patients had good clinical evidence of viral infection (Table 1).
The 18 serum samples were analysed by commercial B. burgdorferi IgG/IgM EIA (Zeus Scientific, New Jersey, USA) and an in-house B. burgdorferi IgG Western blot. The EIA was performed according to the manufacturer's instructions and the Western blot was performed as described previously.2
The blots used contained sodium dodecyl sulphate-extracted B. burgdorferi (i.e., antigen). A commercial positive control (Zeus Scientific) and in-house positive control, with defined band patterns, were included in each blot run. The number, intensity and molecular weight of bands observed with each sample were recorded, and a negative, equivocal, weak positive or positive result assigned according to predetermined criteria.3 The Western blot was repeated for all samples.
Previous or subsequent serum samples from five patients (serum samples 5,8. 9,11 and 12
