Nikhil Prasad Fact checked by:Thailand Medical News Team Mar 06, 2026 1 hour, 50 minutes ago
Medical News:
Growing Concerns Over Lyme Disease Diagnosis
Lyme disease is one of the most common infections transmitted by tick bites, yet diagnosing it accurately remains a major challenge. Scientists are now warning that commonly used blood tests may miss a significant number of infections, potentially leaving patients untreated and vulnerable to serious complications.
Researchers warn that some commonly used Lyme disease blood tests may fail to detect infections, potentially
delaying treatment for patients
Researchers from Innatoss Laboratories B.V., Oss, The Netherlands, and Deventer Hospital, Deventer, The Netherlands, conducted a detailed investigation into the accuracy of several widely used laboratory tests designed to detect antibodies against the bacteria that cause Lyme disease. Their findings raise concerns that certain diagnostic methods may fail to identify infections that other tests can detect.
How Lyme Disease Is Normally Diagnosed
Lyme disease is caused by bacteria belonging to the Borrelia burgdorferi group, which are transmitted to humans through infected tick bites. Early symptoms can include fatigue, fever, headaches, joint pain, and a characteristic skin rash known as erythema migrans. However, many people never notice the tick bite or the rash, making laboratory testing crucial for diagnosis.
Doctors typically rely on serological tests that detect antibodies produced by the immune system after infection. These tests are usually performed in a two-step process known as “two-tier testing.” If the first test suggests exposure to the bacteria, a second confirmatory test is performed.
However, this
Medical News report highlights that not all testing systems perform equally well.
Study Reveals Major Differences Between Tests
The researchers analyzed blood samples collected during a large annual Lyme screening program involving individuals who are regularly exposed to ticks through outdoor work such as forestry, landscaping, and agriculture.
In the study, 60 blood samples that previously tested positive for Borrelia antibodies were reexamined using three different commonly used testing protocols. The results revealed clear differences in diagnostic sensitivity.
One testing approach combining EUROIMMUN and ZEUS ELISA methods detected approximately 96.8 percent of infections, making it the most sensitive protocol. By comparison, the SERION ELISA protocol detected about 84.1 percent, while the Diasorin CLIA method detected only 69.8 percent of cases.
This means some infected individuals could receive negative results simply because a less sensitive testing system was used.
Real-World Consequences of Missed Diagnoses
The study also examined real patient cases where test discrepancies led to confusion in clinical care.
In two cases, individuals tested
positive during routine screening, showing increasing levels of antibodies that strongly suggested a recent infection. However, when their doctors ordered repeat testing at other laboratories using different diagnostic systems, the results came back negative. As a result, those patients were not immediately treated for Lyme disease.
In another example, a teenage patient suffering from fatigue, headaches, and joint pain initially tested negative using one test system. When the same samples were analyzed using a different testing protocol, the infection was detected and the patient received antibiotic treatment. After therapy, the symptoms improved.
These cases demonstrate how variations in test performance can delay treatment and prolong illness.
Why Some Tests Perform Differently
Scientists believe that the differences may be related to the specific bacterial proteins, known as antigens, used in the various tests. Some assays use a broader range of antigens or more sensitive detection methods, allowing them to identify antibodies that other tests miss.
Another challenge is that antibody levels can change over time. Comparing current blood results with previous samples from the same person can help detect new infections that might otherwise be overlooked.
Conclusion
The researchers stress that improving Lyme disease diagnostics is critical to protecting patients. Differences between testing systems mean that infections can be missed depending on which assay is used. Greater standardization of testing protocols, broader use of more sensitive assays, and routine comparison of current and past blood samples could significantly improve detection rates. Better diagnostic accuracy would allow doctors to identify infections earlier, start treatment sooner, and prevent the long-term complications that can arise when Lyme disease remains undiagnosed.
The study findings were published on a preprint server and are currently being peer reviewed.
https://www.medrxiv.org/content/10.1101/2025.03.24.25323417v2
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