Questen about Labresults (infectolab Augsburg)

Medical topics with questions, information and discussion related to Lyme disease and other tick-borne diseases.
Aubry
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Joined: Tue 2 Sep 2014 18:55

Questen about Labresults (infectolab Augsburg)

Postby Aubry » Tue 2 Sep 2014 18:59

Hello,

Recently I've got my labresults from Augsburg, but I don't really understand... I know I have a chlamydia pneumoniae infection (recently discoverend, treatment: Azithromicine), but I my Lyme tests are doubtfull.. Any suggestions or interpretations? Also, my CD57 is very low, if I search the internet it says this could be due Lyme, Chlamydia Pneumoniae and Tuberculosis...

Best Regards,
Aubry
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LHCTom
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Re: Questen about Labresults (infectolab Augsburg)

Postby LHCTom » Thu 11 Sep 2014 21:52

A few questions?

Why were you tested for Lyme?
Tick bite history? Where and when?
Symptoms? How long? Recent, months or years?
I presume you live in Europe since Infectolab was chosen?
What is the criteria used by Infectolab for IgG and IgM?
What antigens do they use for the main Blot? B garinii (Bg) and/or B afzelii (Ba)? except the VlsE which appears to use all 3 (Bb, Ba and Bg) -
This would make their test a broader genotype net than used in the US.
This matters based on if you live in the US or Europe? and what species is suspected based on where you live?

You could ask for the actual blot itself. Some labs use people to read blot bands while others use optical readers that measure darkness. But its very nice to see the blot itself since the bands can be off on the kilodalton scale and there is nothing like seeing the band darkness yourself. Most labs won't provide it but Infectolab may be different. Just a thought.

Your IgG blot is very negative with only the highly specific OspC borderline being of even marginal significance.
Many test positive for the p41 flagella which occurs on many bacteria.

If you had a few Lyme significant IgG antibodies, that would be suspicious but you don't.
The Elispot was also negative.

The low CD57 is a marker on Killer T cells that varies as a result of a variety of conditions and is not exclusive to Lyme so has little meaning especially in the context of no WB antibody evidence and a negative Elispot.

If you have other reasons to suspect Lyme, you might ask for a C6 peptide ELISA and/or a WB at a different reliable lab if you want to be very sure.

I'm not a doctor but have a reasonable amount of experience trying to sort out discordant results from different labs. My opinion, for what its worth, is if you are past the first few months of the illness and don't have a few Lyme specific IgG antibodies from a good lab, its probably not Lyme unless you had an EM or other highly specific symptom. If you want to rule out a lab problem, getting a second WB and C6 from another good lab would be helpful in adding confidence. The C6 does appear to be effective for European species but does miss some strains. It also gives a value which is helpful.
The greater the ignorance, the greater the dogmatism.

Attributed to William Osler, 1902

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ChronicLyme19
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Joined: Mon 11 Aug 2014 17:42
Location: NY, USA

Re: Questen about Labresults (infectolab Augsburg)

Postby ChronicLyme19 » Thu 11 Sep 2014 23:44

I agree what LHCTom has said, it is probably unlikely that you have lyme if you do not have band 41 positive and if you have been sick a while. There is one caveat I would have to add, is make sure your IgM and IgG levels are normal. If you are immunodeficient, which a few of us are, you may not have any or much fewer bands show up on a western blot test. This test is only as good as your immune system is and does not detect the bacteria itself. It's an indirect test.

Question to the rest of the forum, have any of you seen a Lyme test positive without either of the IgM or IgG 41 being positive?
Half of what you are taught is incorrect, but which half? What if there's another half missing?

Aubry
Posts: 2
Joined: Tue 2 Sep 2014 18:55

Re: Questen about Labresults (infectolab Augsburg)

Postby Aubry » Fri 12 Sep 2014 15:08

Hellow,

Thanks for your answers and help!
I live in Belgium (near France and Germany), famous for its beer:D

I started getting sick since april 2014. It began with fatigue... but a lot of symptoms came up the following months till today. Symptoms: headaches, tinnitus, dizziness, strange feeling in my head, difficult when surround by lots of people, extreme fatigue, burning sensations (back, shoulders, legs, feet, buttock, hands, stomach), tingling sensations, somethimes nausea feelings, pain in the knee, ankles, wrists (comes and goes), high blood pressure, rapid heart rate, ...

Before I started getting ill I was really healthy (I suppose), was never sick, did a lot of sport (waterpolo, hicking, running..) It all started with flu-like sympoms the end of April 2014.

I don't remember any EM. But my mom told my in juni that she have seen a tiny little spider in my bed... if it was a tick...? That remains guessing. The weeks after I had a few red rashed on my chest (but nog typically EM), I thought it was some sort of allergy. The rashes did go away pretty fast (1-2 days).

I dit numerous visits to doctors, didn't find anything, exept the Chlamydia Pneumoniae infection (end of August 2014).

I have made an appointment with a good LLMD in Belgium to be sure (he treated Yolanda Foster from America). He knows a lot about the immune system, ME/CFS, co-infections, lyme, ...

Monday I will go to my homedoctor to have an Elisa C6 test, I had have the normal Elisa in Belgium but was negative, just like the tests I did in Augsburg (Germany).

Best Regards,
Aubry

duncan
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Re: Questen about Labresults (infectolab Augsburg)

Postby duncan » Sat 20 Sep 2014 23:46

ChronicLyme19, in answer to your question to the general Forum about ever testing positive without band 41 - I have. At least once, maybe twice. The one time I am certain I did was with the G39/40 strain. I think the other time was a basic B31 kit.

But they were definitely the exception as I have been tested more times than I care to remember. Band 41 has almost always been part of the mix.

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ChronicLyme19
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Location: NY, USA

Re: Questen about Labresults (infectolab Augsburg)

Postby ChronicLyme19 » Mon 22 Sep 2014 0:47

Thanks for sharing Duncan. Good to know. Band 41 is the only one that is consistent for me and it's always really strong. It's one of the few IgGs I still produce. I usually have that and one or two other bands that show up that change.
Half of what you are taught is incorrect, but which half? What if there's another half missing?

Margherita
Posts: 191
Joined: Thu 27 Sep 2012 18:22

Re: Questen about Labresults (infectolab Augsburg)

Postby Margherita » Mon 22 Sep 2014 11:57

Dear Aubry,

There are many reasons why current Elisa/Blot antibody-testing is not sufficiently reliable for the diagnosis of Lyme disease. LHCTom listed up quite a few of them in the following topic:

viewtopic.php?f=5&t=5481&start=30

+ The human immune system are all different genetically and developed differently from birth
+ The Human immune system fluctuates in antibody production over time
+ The levels of antibodies fluctuate over time along with pathogen gene expression variation over time
+ The surface antigen expression and amount and expression time vary by genotype
+ B cells create antibodies on trial and error basis until they get a hit on an epitope the proliferate for this one
+ Not every immune system creates the same set of antibodies matched to the same antigen epitopes
+ The pathogen fluctuates its surface antigens expression over time and variable immune response stress factors
+The immune system produces different antibodies to the same antigen
+ One 41kDa antigen can be as many as hundreds of amino acids with many amino acid epitipe targets
+ Antigens have many epitopes for antibody binding that are all effective for the immune function
+ A typical spirochete might have as many as 20 or more target antigens
+ These epitopes can be anywhere from 3 to dozens of amino acids long and overlap
+ These epitopes can be linear or cross a protein fold
+ The many epitopes per antigen amino acid sequences vary from strain to strain to species in unpredictable ways
+ Genotype variations is a major factor, the slow rate of discovery and admission is a continuing problem
+ All the genotype antigen and their epitope variants is not known
+ Test developers tend to blind themselves and make simplifying assumptions about the above or fail
+ There is lack of competence and leadership on how to handle these variables by suites at the CDC/FDA
+ Anybody brave enough to push for acknowledgement of these issues and coordination is pushed out
+ Test developers only care about special cases like "early testing" to avoid and simplify assumptions
+ Simplifying assumptions lead to test good at one case but used for all cases which doesn't work
+ Success by developers is not measured by how well it performs in the "failed" cases
+ Developer success is measured by old FDA rules and cost/statistical performance
+ Sine a 100% perfect test is impossible, everyone agrees to agree and ignore the "failed" cases as its easier
+ Even the best tests require consistency of implementation at labs which is impossible due to complexity
+ Nobody can afford redundancy which is one way of getting closer to 100%
+Redundancy means multiple optimized tests that together cover as many issues and assumption problems
+ and on and on


Your symptoms fit well into the Lyme picture. Furthermore, in about 50% of the European persons infected with Borrelia, the classic skin rash (Erythema Migrans) doesn't appear at all. So maybe it's a good idea to discuss with your doctor to have an alternative test done. A PCR DNA test (= culture with DNA sequencing which is very specific) or LTT test might be an option as your symptoms started not too long ago. Besides, you wrote that you’re dealing with Chlamydia pneumoniae. It appears that in the European area you live quite some people are infected with this bug. This and other co-infections such as Babesia, Mycoplasma, Erlichia, Candida (=fungus) etc. can cause severe symptoms that are often very similar to those of Lyme disease. Therefore it’s very important to see if you are (also) dealing with one of those infections and that you will be treated for your Chlamydia Pneumoniae infection. By the way: have you been tested for Epstein Barr virus lately? If not, pls. ask your doctor to do so. And if you live in a rural area, then please make sure you will also be tested for Q-fever and Brucellosis.

Example:
http://www.imd-berlin.de/leistungsschwe ... elien.html

By the way, most probably you already know but in case you don't, these might be helpful:

http://www.associationlymesansfrontieres.com/
http://www.belgiumlyme.com/

Wish you all the best.

Turtle pea
Posts: 4
Joined: Sat 21 Jun 2014 15:39

Re: Questen about Labresults (infectolab Augsburg)

Postby Turtle pea » Thu 29 Jan 2015 4:29

I tested negative at Infectolab, however two doctors that were familiar with the disease and how to read the tests looked at the test papers and said "I can see that you have Lyme from this" even the best labs are not perfect in finding Borellia but the test gives clues. I did end up testing postive when Borellia dna was found in my urine through another lab. This is a lesson that a positive test means positive but a negative test means "maybe" so you must continue to investigate. Have you shown a good doctor the test results so they can read between the lines? ..


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