IgM B. afzelii
IgM B. afzelii – Research Overview
IgM B. afzelii testing measures the presence of early antibodies directed against Borrelia afzelii, one of the major European subspecies of the Lyme disease–causing bacteria within the Borrelia burgdorferi sensu lato complex. While B. burgdorferi sensu stricto is most common in North America, B. afzelii is a leading cause of Lyme borreliosis in Europe and Asia.
The Role of IgM Antibodies
The immune system produces IgM antibodies soon after exposure to Borrelia species. In the case of B. afzelii, IgM antibodies typically appear within the first 1–3 weeks following a tick bite. Detecting IgM can indicate:
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Recent or early infection with B. afzelii.
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An ongoing immune response in symptomatic individuals.
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Possible non-specific reactivity or cross-reactivity, which is why results near the cut-off require careful interpretation.
Clinical Significance of B. afzelii
Unlike other Borrelia subspecies, B. afzelii is strongly associated with dermatological forms of Lyme disease, including:
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Acrodermatitis chronica atrophicans (ACA): a late-stage, chronic skin condition.
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Erythema migrans: the classic early “bull’s-eye” rash.
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Other chronic or recurrent skin manifestations.
Because of these clinical patterns, detection of IgM antibodies against B. afzelii is particularly useful in European patients presenting with skin changes, joint involvement, or unexplained neurological symptoms.
Limitations and Considerations
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False positives may occur due to cross-reactivity with other infections or immune system activity.
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An isolated IgM response without IgG development should be interpreted with caution, especially beyond the first 6–8 weeks of illness.
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For stronger diagnostic accuracy, IgM B. afzelii results should be considered alongside other Borrelia markers (e.g., B. burgdorferi sensu stricto, B. garinii, Osp proteins) and the patient’s clinical presentation.
Summary
The IgM B. afzelii marker helps detect early immune responses to a key European subspecies of Lyme disease. A positive result may point to a recent infection, especially when skin involvement is present, but equivocal or borderline results should be confirmed with repeat testing or additional Lyme panels. Together with clinical history and other antibody markers, this test contributes to a more accurate diagnosis of Lyme borreliosis.
What does it mean if your IgM B. afzelii result is too high?
Positive (clearly above the cut-off)
What it means: A positive IgM response to Borrelia afzelii suggests a recent or early infection with this subspecies of the Lyme bacterium. B. afzelii is more commonly found in Europe and is often associated with skin manifestations of Lyme borreliosis, such as acrodermatitis chronica atrophicans (ACA) and other chronic skin changes.
Important to know: A positive IgM result should always be interpreted with other Lyme tests, clinical history, and symptoms before a diagnosis is made.
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