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Lab Dept:
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Microbiolgy/Virology
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Test Name:
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LYME DISEASE PCR, SPINAL OR SYNOVIAL FLUID
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General Information
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Lab Order Codes:
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LYPCR
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Synonyms:
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Borrelia burgdorferi PCR; Lyme Disease PCR; Lyme Disease by Polymerase Chain Reaction
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CPT Codes:
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87476 – Borrelia burgdorferi, amplified probe technique
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Test Includes:
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A positive or negative result indicating the presence or absence of Borrelia burgdorferi DNA in the specimen submitted.
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Logistics
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Test Indications:
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Confirmation of active Lyme Disease. Monitoring Lyme Disease treatment. Diagnosing and monitoring Lyme arthritis.
PCR testing should be limited to patients with at least an equivocal or positive serologic test for antibody to Borrelia burgdorferi.
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Lab Testing Sections:
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Microbiology/Virology – Sendouts
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Referred to:
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Mayo Medical Laboratories (MML Test# 80574)
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Phone Numbers:
Minneapolis:
Saint Paul:
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612-813-6280
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651-220-6550
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Test Availability:
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Daily, 24 hours
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Turnaround Time:
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1 – 4 days
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Special Instructions:
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Testing of CSF by PCR in patients with suspected Lyme neuroborreliosis should be requested only on patients with positive Borrelia burgdorferi antibody in serum confirmed by Western blot assay and with abnormal CSF findings (elevated protein and WBC >10 cells/high power field).
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Specimen
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Specimen Type:
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Spinal (CSF) fluid or Synovial fluid
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Container:
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Screw-capped sterile vial
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Draw Volume:
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1.0 mL (Minimum: 0.5 mL) CSF or Synovial Fluid
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Processed Volume:
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Same as Draw Volume
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Collection:
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CSF/Synovial fluid collection
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Special Processing:
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Lab Staff: Fluid specimen should be in a sterile, screw-capped plastic vial. Maintain sterility. Store at ship at refrigerated temperatures.
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Patient Preparation:
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None
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Sample Rejection:
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Mislabeled or unlabeled specimens
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Interpretive
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Reference Range:
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Negative (reported as positive or negative)
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Critical Values:
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N/A
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Limitations:
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A negative result does not rule out Lyme disease, since inhibitory substances may be present in the specimen and the assay has limited diagnostic sensitivity when testing certain types of specimens. If clinical features of illness are highly indicative of Lyme neuroborreliosis, serologic testing on CSF is warranted.
Patients with active infection due to Borrelia afzelii, or Borrelia garinii may have positive results from this PCR test, which can distinguish Borrelia burgdorferi infection from those of Borrelia afzelii and Borrelia garinii. However, the later 2 infections are indistinguishable from one another by this PCR assay. Specimens with detectable DNA from either of these two sprirochetes in this assay will be reported as “positive” for Borrelia afzelii/Borrelia garini”.
PCR test results should be used as an aid in diagnosis and not considered diagnostic by themselves. These results should be correlated with serologic and epidemiologic data and clinical presentation of the patient.
Coinfection with Erhlichia chaffeensis/Anaplasma phagocytophilum and/or Babesia microti have been reported in the United States.
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Methodology:
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Polymerase Chain Reaction (PCR)/DNA Probe Hybridization
(PCR is utilized pursuant to a license agreement with Roche Molecular Systems, Inc.)
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References:
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Mayo Medical Laboratories Web Page November 2009
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