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HelpTest ID CLYME Lyme Disease Serology, Spinal Fluid
Useful For
Aiding in the diagnosis of Lyme neuroborreliosis
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| CLYWB | Lyme Disease Ab, Immunoblot, CSF | Yes | No |
Testing Algorithm
If Lyme disease serology is positive, then immunoblot testing will be performed at an additional charge.
See Acute Tick-Borne Disease Testing Algorithm in Special Instructions.
Special Instructions
Method Name
Enzyme-Linked Immunosorbent Assay (ELISA)
Reporting Name
Lyme Disease Serology, CSFSpecimen Type
CSFCollection Container/Tube: Sterile vial
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Additional Information: This test is not available for specimens originating in New York.
Forms: If not ordering electronically, complete, print, and send a Neurology Test Request Form-General (T732) with the specimen (http://www.mayomedicallaboratories.com/it-mmfiles/neurology-request-form.pdf)
Specimen Minimum Volume
0.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| CSF | Refrigerated (preferred) | 14 days |
| Frozen | 14 days |
Clinical Information
Lyme disease is caused by the spirochete Borrelia burgdorferi. The spirochete is transmitted to humans through the bite of Ixodes species ticks. Endemic areas for Lyme disease in the United States (US) correspond with the distribution of 2 tick species, Ixodes dammini (Northeastern and Upper Midwestern US) and Ixodes pacificus (West Coast US). In Europe, Ixodes ricinus transmits the spirochete.
Lyme disease exhibits a variety of symptoms that may be confused with immune and inflammatory disorders. Any of the following clinical manifestations may be present in patients with Lyme disease: skin lesions, cardiac disease, or neurological disease. In the first stage of disease, inflammation around the tick bite causes skin lesions, erythema chronicum migrans (ECM)-a unique expanding skin lesion with central clearing that results in a ring-like appearance. Culture of skin biopsies obtained near the margins of ECM are frequently positive. Neurologic and cardiac symptoms may appear with stage 2, and arthritic symptoms with stage 3 of Lyme disease. In some cases, a definitive distinction between stages is not always seen. Further, secondary symptoms may occur even though the patient does not recall a tick bite or rash.
The presence of cerebrospinal fluid antibodies to Borrelia burgdorferi is indicative of neurologic Lyme disease (Lyme neuroborreliosis). PCR testing also may be used to confirm late-stage neurologic disease.
Early antibiotic treatment of Lyme disease can resolve clinical symptoms and prevent progression of the disease to later stages. Treatment with beta lactams such as amoxicillin, cefixime or ceftriaxone, or doxycycline are considered the most appropriate therapy.
Reference Values
Negative
Reference values apply to all ages.
Cautions
A negative result does not rule-out Lyme neuroborreliosis.
According to the manufacturer’s package insert, patients in early stages of infection may not produce detectable levels of antibody. Antibiotic therapy in early disease may prevent antibody production from reaching detectable levels.(1) Patients with clinical history and/or symptoms suggestive of Lyme disease or where early Lyme disease is suspected, but with negative test results should be retested in 2 to 4 weeks.
Results should be interpreted in the context of clinical findings.
False-positive results may be caused by breakdown of the blood-brain barrier, or by the introduction of blood into the cerebrospinal fluid at collection.
Because clinical studies are limited, the advantage of immunoassays over PCR (or vice versa) has not been conclusively demonstrated for diagnosing central nervous system Lyme disease. If the result for the immunoassay is negative and there is a high suspicion of Lyme neuroborreliosis, consider performing PBORR / Lyme Disease (Borrelia burgdorferi), Molecular Detection, PCR.
Day(s) Performed
Monday through Friday; 10 a.m.
Report Available
Same day/1 dayPerforming Laboratory
Mayo Medical Laboratories in Rochester
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.CPT Code Information
86618-Lyme disease serology
86617 x 2-Lyme blot (if appropriate)