Sorted By Test Name - Mayo Medical Laboratories

FBBIA
91898
FBBAB
91309
Serology is currently the diagnostic method of choice for Lyme disease. The Second National Conference
on the Serologic Diagnosis of Lyme Disease (1994) recommended that laboratories use a 2-test approach
for the serologic diagnosis of Lyme disease. Accordingly, specimens are first tested by the more sensitive
EIA or enzyme-linked immunosorbent assay (ELISA). A Western blot (WB) assay is used to confirm
positive Lyme EIA or ELISA results due to the presence of IgG- or IgM-class antibodies. WB identifies
the specific proteins to which the patient's antibodies bind. Although there are no proteins that specifically
diagnose Borrelia burgdorferi infection, the number of proteins recognized in the WB assay is correlated
with diagnosis. Since serology may not be positive until 2 to 4 weeks after onset of ECM, direct detection
of Borrelia burgdorferi-specific target DNA sequences using PCR is a promising adjunct to existing
diagnostic tests. PCR has shown utility for detection of Borrelia burgdorferi DNA from skin biopsies of
ECM lesions, and from synovial and cerebrospinal fluid in late-stage disease. Borrelia burgdorferi DNA
can also, rarely, be detected from blood, but is not the test of choice from this source.
Useful For: Confirmation of active Lyme disease Monitoring Lyme disease treatment PCR testing
should be limited to patients with a positive, or at least an equivocal, serologic test for antibody to
Borrelia burgdorferi.
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 diagnostic sensitivity limitations of the PCR assay, a negative result does not
preclude the presence of the organism or active Lyme disease.
Reference Values:
Not applicable
Clinical References: 1. Keller TL, Halperin JJ, Whitman M: PCR detection of Borrelia burgdorferi
DNA in cerebrospinal fluid of Lyme neuroborreliosis patients. Neurology 1992;42:32-42 2. 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 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. Reed KD: Laboratory testing for
Lyme disease: possibilities and practicalities. J Clin Microbiol 2002;40:319-324 5. 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 6. 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 Antibody (IgG), IBL (CSF)
Reference Values:
REFERENCE RANGE: No Bands Detected
No interpretive criteria for Lyme Disease (Borrelia burgdorferi) immunoblot have been established for
CSF. The presence of reactive antibodies in CSF may represent either compartmental antibody production
or transudation of plasma antibody. Immunoblot assays may be used to confirm the presence of B.
burgdorferi-specific antibodies detected in screening assays (ELISA, IFA).
Test Performed by: Focus Diagnostics, Inc.
5785 Corporate Ave.
Cypress, CA 90630-4750
Lyme Disease Antibody Index for CNS Infection
Reference Values:
Lyme Disease Antibody Index:
< or = 1.0 Negative
1.1 - 1.2 Equivocal
Current as of January 4, 2013 7:15 pm CST 800-533-1710 or 507-266-5700 or MayoMedicalLaboratories.com Page 1128