84002:LYME ANTIBODIES, IgG & IgM, CEREBROSPINAL FLUID (CSF) by WESTERN BLOT

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84002:LYME ANTIBODIES, IgG & IgM, CEREBROSPINAL FLUID (CSF) by WESTERN BLOT
Alias Names: Borrelia Burgdorferi / B. burgdorferi
Methodology: Western Blot (WB)
Edit Date: 6/11/2010
Performed: Sunday, Tuesday, Thursday, Friday
Released: 72 hours after setup at PeaceHealth Laboratories’ reference lab.
CPT Code: 86617-90 x2
Specimen Collection Details
Collection: 3 mL cerebrospinal fluid (CSF) in sterile, plastic vial.
Handling: Mark sample plainly as ‘acute’ or ‘convalescent’. Refrigerate.
Stability: 8 hours ambient, 2 weeks refrigerated, or 1 year frozen.
Standard Volume: 3 mL CSF.
Minimum Volume: 2 mL CSF.
Transport: Refrigerated.
Rejection Criteria: Contaminated or heat-inactivated specimen.

Reference Interval: IgG Positive: Any five of the following 10 bands: 18, 23, 28, 30, 39, 41, 45, 58, 66, 93 kDa
IgG Negative: Any pattern that does not meet the IgG-positive criteria.
IgM Positive: Any two of the following three bands: 23, 39, 41 kDa
IgM Negative: Any pattern that does not meet the IgM-positive criteria.
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.

A negative result indicates that the Western blot evaluation for Borrelia burgdorferi antibody demonstrates no antibodies unique to Borrelia burgdorferi, and therefore is not supportive of Lyme disease.

A positive result indicates that the Western blot evaluation for Lyme antibody is consistent with the presence of antibody produced by patients in response to infection by Borrelia burgdorferi and suggests the presence of Lyme disease. Although the test has been shown to have a high degree of reliability for diagnostic purposes, laboratory data should always be correlated with clinical findings.

Current CDC recommendations for the serological diagnosis of Lyme disease are to screen with a polyvalent ELISA test and confirm equivocals and positives with Western blot. Both IgM and IgG Western blots should be performed on samples obtained less than four weeks after appearance of erythema migrans. Only IgG Western blot is to be performed on samples greater than four weeks after disease onset. IgM Western blot in the chronic stage is not recommended and does not aid in the diagnosis of neuroborreliosis or chronic Lyme disease.