The NICE guideline recommends that clinicians support their judgement with a combination of tests - an enzyme-linked immunosorbent assay (ELISA) test for both IgM and IgG antibodies using ELISAs based on purified or recombinant antigens derived from the VlsE protein or its IR6 domain peptide (such as C6 ELISA), and if the ELISA is positive or equivocal perform an immunoblot test.
Not all patients with Lyme disease will deliver positive tests, which is why the guideline has been updated to allow antibiotic treatment before test results are known.
The ELISA test may be repeated 4-6 weeks later if Lyme disease is still suspected in people who had a negative ELISA result within 4 weeks of the onset of symptoms.
Editor's Note: This quiz was first published in April 2018 and updated with the latest information from NICE in February 2019.
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Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: Tim Locke. UK Guidelines Quiz: Do You Know The Latest on Managing Lyme Disease? - Medscape - Feb 12, 2019.
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