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Lyme Disease Message Board

Lyme Disease Board Index

Am I reading this wrong? Why do I see so many people posting that Lyme testing is so innacurate at the late stages, and then this same group of people seem to go on about promoting this Igenex lab... it looks to me like the standard test is 100% accurate in Late stage...(see the bottom line) what is the real deal here people?

Serology is the standard of diagnosis in later stages of the disease.
Reported specificity of Lyme serology is only 90-95%. Therefore, the positive predictive value of the test is highly dependent on the prevalence of disease. Lyme serology should not be performed in children with nonspecific symptoms and no history of exposure or in children in nonendemic areas.
Antibodies are known to persist for many years despite eradication of the infection. Hence, diagnosis of repeat infection or evidence of cure can be difficult based on serology alone.
Serology should include a two-step process. First, perform enzyme-linked immunosorbent assay (ELISA) or immunofluorescent assay (IFA) and, if positive, go to the second step. This next step involves Western blot analysis against specific antigens. This step is not interpretable in the absence of a positive ELISA or IFA result. Most assays require immunoglobulin against at least 3 specific proteins (for immunoglobulin M [IgM]) or 5 specific proteins (for immunoglobulin G [IgG]) for results to be considered positive. Patients with early Lyme disease who are treated with antibiotics may never develop positive titer results.

Early disease: Only one third of patients have a positive titer result; therefore, clinicians rely on the presence of the rash to make the diagnosis. For patients without an EM rash but in whom Lyme disease is suspected, serial titers eventually can be used to confirm the diagnosis.

Early disseminated disease: Ninety percent of patients have a positive titer result.

Late disease: One hundred percent of patients have a positive titer result.

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