Confused about Labs

[StillHopeful]

Hi -

 

I was reviewing my son's lab work and I noticed that he has a pos C6 IgG/IgM (2.42) and band 41 on WB was present. He is neg for the WB bands and neg for Bartonella, Babesia and Erlichia. I was told by his PANDAS doc (who ordered the test) and our pediatrican that he does not have Lyme. But now I am second guessing that diagnosis since they are not LLMDs. I know the band 41 could be from another infection but what does the C6 mean? Thank you.

[MichaelTampa]

Just googling it, looks like C6 is the ELISA style test for borrelia (lyme). Having a positive on that by itself it pretty meaningful, and that in combination with positive on band 41, to me, suggests very high probability that lyme is involved. I think most PANDAS docs really don't know enough about lyme to be diagnosing/non-diagnosing it.

[GinnyO]

A friend shared this with me, but I don't know the source. My only + IgM was 41, and my Lyme MD considers me positive. I began treatment this spring, 6 years after infection.

 

 

Western Blot bands:

9 cross-reactive for Borrellia

12 specific for Bb

18 unknown

20 cross-reactive for Borrellia

21 unknown

22 specific for Bb, probably really the 23/25 band

23-25 outer surface protein C (OspC), specific for Bb

28 unknown

30 unknown; probably an outer surface protein; common in European and one California strain

31 outer surface protein A (OspA), specific for Bb

34 outer surface protein B (Osp; specific for Bb

35 specific for Bb

37 specific for Bb

38 cross-reactive for Bb

39 is a major protein of Bb flagellin; specific for Bb

41 flagellin protein of all spirochetes; this is usually the first to appear after a Bb infection and is specific for all Borrellia

45 cross-reactive for all Borellia (sometimes people with Lyme who have this band positive also have the co-infection Ehrlichiosis)

50 cross-reactive for all Borrellia

55 cross-reactive for all Borrellia

57 cross-reactive for all Borrellia

58 unknown but may be a heat-shock Bb protein

60 cross reactive for all Borrellia

66 cross-reactive for all Borrelia, common in all bacteria

83 specific antigen for the Lyme bacterium, probably a cytoplasmic membrane

93 unknown, probably the same protein in band 83, just migrates differently in some patients The IgM tests for a more recent infection, the IgG a longer standing one. Band 41 is often the first to show

[StillHopeful]

Thank you for your post. Just wondering if you could share what your treatment is and how you are feeling?

[StillHopeful]

MichaelTampa, I think you are probably right. We are treating for PANDAS right now guess I should look for an LLMD. Thank you for your post.

[Hopeny]

Just to add it is important to understand which lab did the tests. Quest tests for, if I am recalling correctly, 20 strains of BB while Igenex tests for 300. Igenex (and stonybrook if you ask) will report all bands, for reasons of conflict of interest on the part of the guideline authors in relation to patents they hold and investment/funding from insurance companies, the guideline authors failed to include some Lyme bands that are considered diagnostic by most LLMD's. So the Quest test may not report for example 93 (I'm not sure specifically if they report this one, this is an example) while this band has been shown to indicate Lyme in something like 100% of patients where it is positive.

 

My recommendation for you would be to pursue an evaluation with an LLMD and additional testing by Igenex or Stonybrook, as Band 41 can be the first to show up. It also cross reacts as Dr J told me with hundreds of other infections, so most LLMD's usually disregard that band and focus on the others mentioned. Good luck

[msimon3]

It is good that you are second-guessing the diagnosis. You should get an Igenex Western Blot to verify your results.

 

The CDC Lyme criteria is considered flawed and too narrow based on the opinion of many enlightened LLMDs. There is a rich history on how this happened, please read Cure Unknown or see Under Our Skin for a primer.

 

C6 is an ELISA test for an antibody matches a single synthetic peptide derived from a protein from Borrelia. The Western Blot is a test that measures antibody stickiness to a range of proteins from Borrelia (e.g. OspA, OspB, OspC).

 

On the Western Blot, 41 kDa can be any flagellate bacteria and may be a false-positive for Borrelia. However, traditional test labs following the CDC criteria specifically exclude bands 31 and 34 from the WB test. In other words, if you had bands 31 and 34, a traditional lab would not show it.

 

CDC-based WB tests for one Borrelia strain only: B31. Igenex tests for two: B31 and 297.

 

References:

http://www.igenex.com/labtest.htm

http://www.ilads.org/lyme_disease/about_lyme.html

http://www.igenex.com/innovations3.pdf

http://www.jemsekspecialty.com/lyme_detail.php?sid=9

http://www.ticktalkireland.org/elisavswb.html