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(NOTE: The standard tests for Lyme Disease do not look for the bacteria, but rather the immune system's response to the bacteria. The ELISA and Western Blot both test for antibodies which is what the immune system produces when infection is present. Because the tests look for this indirect measure of infection, false negatives are not uncommon.) A. Antibodies against Bb are present, but the laboratory is unable to detect them. [Borrelia burgdorferi (Bb) is the Lyme disease bacteria.] B. Antibodies against Bb may not be present in detectable levels in patients with Lyme disease. Reasons are listed below. 1. The patient is currently on, or has recently taken, antibiotics. The antibacterial effect of antibiotics can reduce the body's production of antibodies. 2. The patient is currently on or has previously taken anti-inflammatory steroidal drugs (such as those taken to treat rheumatoid arthritis) or certain anticancer drugs. These can suppress a person's immune system, thus reducing or preventing an antibody response. 3. The patient's antibodies may be bound with the bacteria with not enough free antibodies available for testing. [I think this reason is very important and prevalent. For this reason, some of the worst cases of Lyme disease test negative - too much bacteria for the immune system to handle.] 4. The patient could be immunosuppressed for a number of other reasons and the immune system is not reacting to the bacterium. 5. The bacterium has changed its makeup (antigenic shift) limiting recognition by the patient's immune system. 6. The patient's immune response has not been stimulated to produce antibodies, i.e., the blood test is taken too soon after the tick-bite (2-6 weeks). Please do not interpret this statement as implying that you should wait for a positive test to begin treatment. 7. The laboratory has raised its cutoff so high that a patient's previously positive test is now borderline or negative. 8. The patient is reacting to the Lyme bacterium, but is not producing the "right" bands to be considered positive. Lyme Disease Foundation 1 Financial Plaza Hartford, CT 06103 (860)525-2000 fax (860)525-TICK Lyme Disease National Hotline (800)886-LYME email: mailto:lymefnd@aol.com For more on false negative/positive Lyme disease test results see: Lyme disease and false negative or false positive blood test results |
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