High frequency of false positive IgM immunoblots for Borrelia burgdorferi in Clinical Practice

• Published in: Clinical microbiology and infection Vol. 18; no. 12; pp. 1236 - 1240
• Main Authors: Seriburi, V., Ndukwe, N., Chang, Z., Cox, M.E., Wormser, G.P.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Elsevier Ltd 01.12.2012; Blackwell Publishing Ltd; Wiley-Blackwell; Elsevier Limited
• Subjects: Adult; Aged; Antibodies, Bacterial - blood; Bacterial diseases; Biological and medical sciences; Borrelia burgdorferi; Borrelia burgdorferi - immunology; Borrelia infections; Clinical Laboratory Techniques - methods; Clinical medicine; diagnosis; False Positive Reactions; Female; Human bacterial diseases; Humans; IgM immunoblot; Immunoblotting - methods; Immunoglobulin M - blood; Infectious diseases; Lyme disease; Lyme Disease - diagnosis; Male; Medical sciences; Middle Aged; serology; Tropical bacterial diseases; Lyme disease; diagnosis; Borrelia burgdorferi; IgM immunoblot; serology; Spirochaetaceae; Spirochaetales; False positive; Borrelia infection; Serology; IgM; Infection; Spirochaetosis; Bacteriosis; Immunoblotting assay; Bacteria; Diagnosis; High frequency
• ISSN: 1198-743X; 1469-0691
• DOI: 10.1111/j.1469-0691.2011.03749.x

Although it is known that two-tier serologic testing for Lyme disease may be associated with false positive results on the IgM immunoblot, this problem has never been systematically studied in the clinical practice setting. In a retrospective investigation of patients referred to the private adult practice of an Infectious Diseases physician for possible for Lyme disease, 50 of 182 patients (27.5%, 95% CI: 21.1-34.6) were found to have a false positive IgM immunoblot. 78.0% of these patients had received unnecessary antibiotic therapy. False positive results were not restricted to any single commercial laboratory. Research on alternative testing strategies that eliminate the IgM immunoblot entirely is warranted.