Borrelia burgdorferi (Lyme), VlsE1/pepC10 Antibodies, CSF, Total by ELISA With Reflex to IgM and IgG by Immunoblot (Standard Two-Tier Testing, CSF)

Label Mnemonic:	CLYMEAB
Epic code:	LAB2654
Downtime form:	Doctor/Provider Orders - Pathology Core and Specialty Care Nursery

Commercial Mailout Laboratory
6240-8 RCP
356-8593

Specimen(s):

CSF

Collection Medium:

CSF collection kit

Minimum:

Preferred Minimum: 6 mL CSF
Absolute Minimum: 2.5 mL CSF

With a traumatic tap CSF from tube #3 is preferred.

Rejection Criteria:

Bacterially contaminated, heat-inactivated, hemolyzed, or xanthochromic specimens.

Turn Around Time:

1-4 days upon receipt at reference laboratory

Reference Range:

0.90 IV: Negative - VlsE1 and pepC10 antibodies to B. burgdorferi not detected.

0.91-1.09 IV: Equivocal - Repeat testing in 10-14 days may be helpful.
1.10 IV or greater: Positive - VlsE1 and pepC10 antibodies to
                     B. burgdorferi detected.

Interpretive Data:

The detection of antibodies to Borrelia burgdorferi in cerebrospinal fluid may indicate central nervous system infection. However, consideration must be given to possible contamination by blood or transfer of serum antibodies across the blood-brain barrier. Lyme disease diagnosis in serum is recommended prior to any CSF studies.

Comments:

Note - Once this test is performed, if:
  a) Negative - no further testing is done.
  b) Positive or equivocal - Immunoblot testing will be performed on
     the original sample upon receiving a request. Sample will be held
     for 30 days only.

Methodology:

Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Qualitative Immunoblot

CPT Code:

86618, 86617x2 if reflex