Sorted By Test Name - Mayo Medical Laboratories

CLYME
83856
diagnosis.
Useful For: Diagnosing Lyme disease As a sensitive screening (enzyme-linked immunosorbent assay
[ELISA]) test for Lyme disease
Interpretation: Negative result: no antibody to Borrelia burgdorferi detected. This result does not
exclude the possibility of Borrelia burgdorferi infection. 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. 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. Equivocal result: the imprecision inherent in any method implies a lower degree of
confidence in the interpretation of specimens with absorbance values very close to the calculated cutoff
value. For this reason an equivocal category has been designated. Equivocal specimens will be tested by
Western blot (WB) assays in accordance with Centers for Disease Control and Prevention
(CDC)/Association of Public Health Laboratories (APHL) recommendations. Positive result: antibody to
Borrelia burgdorferi detected. All positive results will be supplemented by retesting the serum by WB for
the detection of IgG and IgM antibodies to Borrelia burgdorferi, in accordance with CDC/APHL
recommendations.
Reference Values:
Negative
Clinical References: 1. Dattwyler RJ: Lyme borreliosis: an overview of clinical manifestations. Lab
Med 1990;21:290-292 2. Schwan TG, Burgdorfer W, Rosa PA: Borrelia. In Manual of Clinical
Microbiology. 7th edition. Edited by PR Murray. Washington, DC, ASM Press, 1999, pp 746-758 3.
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
Lyme Disease Serology, Spinal Fluid
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.
Useful For: Aiding in the diagnosis of Lyme neuroborreliosis
Interpretation: Intrathecal synthesis of antibody to Borrelia burgdorferi is indicative of neurological
Lyme disease.
Reference Values:
Negative
Reference values apply to all ages.
Clinical References: Steere AC: Borrelia burgdorferi (Lyme disease, Lyme borreliosis). In
Principles and Practice of Infectious Diseases. 5th edition. Edited by GL Mandell, JE Bennett, R Dolin.
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