Mayo Test Catalog, (Sorted By Test Name) - Mayo Medical ...

CLYME
83856
FLASC
57281
LPMAF
60593
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.
Philadelphia, Churchill Livingstone, 2000, pp 2504-2518
Lyme Serum and CSF Analysis
Reference Values:
A final report will be faxed under separate cover.
Test Performed by: IMUGEN Reference Diagnostic Division
315 Norwood Park South
Norwood, MA 02062
Lymphocyte Proliferation Panel for Mitogens and Antigens
Clinical Information: Several classes of ligands are capable of inducing blastogenesis and
stimulating proliferation of lymphocytes in vitro, including plant mitogens (phytohemagglutinin [PHA],
pokeweed [PWM], and concanavalin A [Con A]), bacterial products and superantigens (potent bacterial
toxins that at low concentrations have the ability to activate large numbers of T cells), and phorbol esters.
Cellular proliferation follows a complex series of signals that begins with engagement of lymphocyte
surface receptors by a mitogenic or antigenic ligand. Subsequent signals, including gene activation and
secretion of cytokines, result in synthesis of DNA and cell division. Measurement of mitogen-induced
lymphocyte proliferation in vitro provides a semiquantitative assessment of total cell-mediated
immunity.(1) The proliferative responses to PHA and Con A involve T lymphocytes, and the response to
PWM involves both T and B lymphocytes in a T-dependent manner. Diminished proliferative responses
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