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. 2022 Apr;41(4):671-675.
doi: 10.1007/s10096-021-04366-4. Epub 2022 Jan 28.

Introduction of IgM testing for the diagnosis of acute Lyme borreliosis: a study of the benefits, limitations and costs

Greg Joyner  1 , Sally Mavin  2 , Rachel Milner  1 , Chin Lim  1
Affiliations

Introduction of IgM testing for the diagnosis of acute Lyme borreliosis: a study of the benefits, limitations and costs

Greg Joyner et al. Eur J Clin Microbiol Infect Dis. 2022 Apr.

Abstract

Testing for IgM antibodies to Borrelia burgdorferi in Scottish patients with suspected Lyme borreliosis was introduced in 2018 to supplement the IgG testing already in situ. Results from 2018 to 2020 were assessed alongside available clinical data to evaluate the utility of IgM testing in serum. An estimated false positive rate of 25.5% was observed with IgM immunoblot vs 80.1% for IgM chemiluminescent immunoassay (CLIA). IgM testing can aid earlier diagnoses if used within a selective two-tier testing protocol: only patients with acute onset of symptoms should be tested for IgM CLIA but confirmation by immunoblot and consideration of clinical picture is necessary.

Keywords: Borrelia; Diagnostics; IgM; Lyme borreliosis; Serology.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram showing the distribution of immunoblot results (1 June 2018 to 14 April 2020) and the allocation of isolated IgM immunoblot patients into the four groups based on the likelihood of acute Lyme borreliosis (LB)
Fig. 2
Fig. 2
Flow diagram showing the distribution of CLIA results (15 April 2018 to 17 October 2020) and the allocation of positive IgM CLIA confirmed by IgM immunoblot samples and patients into the four groups based on the likelihood of acute Lyme borreliosis (LB)
See this image and copyright information in PMC

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