Sorted By Test Name - Mayo Medical Laboratories

CYCL
81506
CYCSP
8931
Reference Range: 10-30 ng/mL
Test Performed By:
Medtox Laboratories, Inc.
402 W. County Road D
St. Paul, MN 55112
Cyclospora Stain
Clinical Information: In recent years, Cyclospora cayatenensis has been shown to cause (in humans)
gastroenteritis characterized by watery diarrhea and systemic symptoms such as anorexia, malaise, weight
loss, and general debilitation. The organism which was originally thought to be a cyanobacteria or
blue-green algae is now recognized as a protozoan parasite belonging to the coccidian group. It is similar
in morphology and staining to Cryptosporidium but is approximately twice as large. Diarrhea caused by
Cyclospora has been reported in Nepal, the Indian subcontinent, Southeast Asia, and Latin America. It has
been extensively studied in Peru and the species name derives from the university where this work was
done. Although most cases of cyclosporiasis have been seen in travelers to developing countries, a focal
outbreak due to contaminated water occurred at a Chicago medical center in 1990. Also, in the summer of
1996, a widespread outbreak occurred in many areas of the United States and Canada due to the
importation of contaminated raspberries from Guatemala. Transmission is probably fecal-oral and can be
food borne or water-borne. The infection is usually self-limited but symptoms can be prolonged. The
infection usually responds to treatment with a sulfa-trimethoprim combination.
Useful For: The identification of Cyclospora as a cause of infectious gastroenteritis See Parasitic
Investigation of Stool Specimens Algorithm in Special Instructions for other diagnostic tests that may be
of value in evaluating patients with diarrhea.
Interpretation: A report of Cyclospora species indicates the presence of this parasite in the patient's
feces.
Reference Values:
Negative
If positive, reported as Cyclospora species
Clinical References: Soave R: Cyclospora: an overview. Clin Infect Dis 1996;23:429-437
Cyclosporine, Blood
Clinical Information: Cyclosporine is a lipophilic polypeptide used to prevent rejection after solid
organ transplantation; it suppresses T-cell activation by inhibiting calcineurin to decrease interleukin-2
(IL-2) production. There is substantial interpatient variability in absorption, half-life, and other
pharmacokinetic parameters. Cyclosporine is extensively metabolized by CYP3A4 to at least 30
less-active metabolites, many of which are detected by immunoassays. Cyclosporine is known for many
drug interactions, including increased neuro- and nephrotoxicity when coadministered with antibiotics,
antifungals, or other immunosuppressants. Cyclosporine has a narrow therapeutic range with frequent
adverse effects making therapeutic drug monitoring essential. With 80% of cyclosporine sequestered in
erythrocytes, whole blood is the preferred specimen for analysis. Dose is adjusted initially (up to 2 months
posttransplant) to maintain concentrations generally between 150 ng/mL to 400 ng/mL. Target trough
concentrations vary according to clinical protocol and depend on type of allograft, risk of rejection,
concomitant immunosuppressive drugs, and toxicity. After the first 2 postoperative months, the target
range is generally lower, between 75 ng/mL to 300 ng/mL. Conversion between formulations is generally
done at the same dose but with drug monitoring.
Useful For: Monitoring whole blood cyclosporine concentration during therapy, particularly in
individuals coadministered CYP3A4 substrates, inhibitors, or inducers Adjusting dose to optimize
immunosuppression while minimizing toxicity Evaluating patient compliance
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