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EEPC<br />

83917<br />

EEEP<br />

83155<br />

also be useful to evaluate patient compliance<br />

Interpretation: Therapeutic ranges are not well-established, but literature suggests that patients<br />

receiving duloxetine monotherapy for depression responded well when trough concentrations were 60 to<br />

120 ng/mL. Higher levels may be tolerated by individual patients. The therapeutic relevance of this<br />

concentration range to other uses of duloxetine therapy is currently unknown.<br />

Reference Values:<br />

60-120 ng/mL<br />

Clinical References: 1. Westanmo AD, Gayken J, Haight R: Duloxetine: a balanced and selective<br />

norepinephrine- and serotonin-reuptake inhibitor. Am J Health-Syst Pharm 2005;62:2481-2490 2.<br />

Waldschmitt C, Vogel F, Pfuhlmann B, Hiemke C: Duloxetine serum concentrations and clinical effects.<br />

Data from a therapeutic drug monitoring (TDM) survey. Pharmacopsychiatry 2009;42:189-193<br />

Eastern Equine Encephalitis Antibody Panel, IgG and IgM,<br />

Spinal Fluid<br />

Clinical Information: Eastern equine encephalitis (EEE) is within the alphavirus group. It is a<br />

low-prevalence cause of human disease in the Eastern and Gulf Coast states. EEE is maintained by a cycle<br />

of mosquito/wild bird transmission, peaking in the summer and early fall, when man may become an<br />

adventitious host. The most common clinically apparent manifestation is a mild undifferentiated febrile<br />

illness, usually with headache. Central nervous system involvement is demonstrated in only a minority of<br />

infected individuals, and is more abrupt and more severe than with other arboviruses, with children being<br />

more susceptible to severe disease. Fatality rates are approximately 70%. Infections with arboviruses can<br />

occur at any age. The age distribution depends on the degree of exposure to the particular transmitting<br />

arthropod, relating to age, sex, and occupational, vocational, and recreational habits of the individuals.<br />

Once humans have been infected, the severity of the host response may be influenced by age.<br />

Useful For: Aiding the diagnosis of Eastern equine encephalitis<br />

Interpretation: Detection of organism-specific antibodies in the cerebrospinal fluid (CSF) may<br />

suggest central nervous system infection. However, these results are unable to distinguish between<br />

intrathecal antibodies and serum antibodies introduced into the CSF at the time of lumbar puncture or<br />

from a breakdown in the blood-brain barrier. The results should be interpreted with other laboratory and<br />

clinical data prior to a diagnosis of central nervous system infection.<br />

Reference Values:<br />

IgG:

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