Sorted By Test Name - Mayo Medical Laboratories

PBORB
87973
Europe and North America (CDC). Lyme disease exhibits a variety of symptoms that may be confused
with immune and inflammatory disorders. Inflammation around the tick bite causes skin lesions.
Erythema (chronicum) migrans (ECM), a unique expanding skin lesion with central clearing that has a
ring-like appearance, is typically the first stage of the disease. Arthritis, neurological disease, and cardiac
disease may be later stage manifestations. Serology is currently the diagnostic method of choice for Lyme
disease. However, serology may not be positive until 2 to 4 weeks after onset of ECM, and direct
detection of Borrelia species. Target DNA using PCR may be a useful adjunct to existing diagnostic tests
for acute disease. PCR has shown utility for detection of Borrelia DNA from skin biopsies of ECM
lesions, as well as DNA from synovial and cerebrospinal fluid in late-stage disease.(1) Borrelia DNA can
also, rarely, be detected from blood, but is not the test of choice from this source. Lyme PCR may be
useful for adjunctive testing to support a serologic diagnosis of Lyme disease, and should be performed in
conjunction with FDA-approved serologic tests. PCR results should be correlated with serologic and
epidemiologic data and clinical presentation of the patient.
Useful For: Confirmation of active Lyme disease Supporting the diagnosis of Lyme arthritis Testing of
cerebrospinal fluid (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
LYWB/9535 Lyme Disease Antibody, Western Blot, Serum and with abnormal CSF findings (elevated
protein and WBC >10 cells/high-power field).
Interpretation: A positive result indicates the presence of DNA from Borrelia burgdorferi, the agent
of Lyme disease. A negative result indicates the absence of detectable DNA from Borrelia burgdorferi in
the specimen. Due to the clinical sensitivity limitations of the PCR assay, a negative result does not
preclude the presence of the organism or active Lyme disease.
Reference Values:
Negative
Clinical References: 1. Nocton JJ, Bloom BJ, Rutledge BJ, et al: Detection of Borrelia burgdorferi
DNA by polymerase chain reaction in cerebrospinal fluid with Lyme neuroborreliosis. J Infect Dis
1996;174:623-627 2. CDC: Recommendation for test performance and interpretation. From second
national conference on serological diagnosis of lyme disease. MMWR Morb Mortal Wkly Rep
1996;45:481-484 3. Nocton JJ, Dressler F, Rutledge BJ, et al: Detection of Borrelia burgdorferi DNA by
polymerase chain reaction in synovial fluid from patients with Lyme arthritis. N Engl J Med
1994;330:229-234 4. Babady NE, Sloan LM, Vetter EA, et al: Percent positive rate of Lyme real-time
polymerase chain reaction in blood, cerebrospinal fluid, synovial fluid, and tissue. Diagn Microbiol Infect
Dis 2008;62(4):464-466
Lyme Disease (Borrelia burgdorferi), Molecular Detection, PCR,
Blood
Clinical Information: Lyme disease is a multisystem and multistage infection caused by 3 species of
tick-borne spirochetes in the Borrelia burgdorferi sensu lato genogroup. These spirochetes include
Borrelia burgdorferi sensu stricto (North America and Western Europe), Borrelia afzelii (Central and
Western Europe and Russia), and Borrelia garinii (Europe, Russia, and northern Asia). Endemic areas for
Lyme disease in the United States 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. 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, is the first stage of the disease. Any of the following clinical manifestations may be present in
patients with Lyme disease: arthritis, neurological disease, cardiac disease, or skin lesions. 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 a rash. Early antibiotic treatment of Lyme disease can
resolve clinical symptoms and prevent progression of the disease to later stages. Treatment with
penicillin, tetracycline, erythromycin, chloramphenicol, or ceftriaxone is considered appropriate therapy.
Current as of January 4, 2013 7:15 pm CST 800-533-1710 or 507-266-5700 or MayoMedicalLaboratories.com Page 1127