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Test Code LYMCSF Borrelia burgdorferi (Lyme Disease) Reflexive Panel (CSF)

Clinical Indications

Preferred CSF reflex panel for workup of suspected neuroborreliosis.

Additional Test Codes

Epic Order Name: LYME DISEASE REFLEX PANEL CSF (aka LYMCSF)
Sunquest Order Code: LYMCSF
Epic Px Code: LAB7043

Specimen Collection Type

CSF

Minimum Collection Volume

2.5 mL

Reference Range

Components

Reference Interval

Borrelia burgdorferi Antibodies, Total by ELISA, CSF

0.99 LIV or less

Negative - Antibody to B. burgdorferi not detected.

1.00-1.20 LIV

Equivocal - Repeat testing in 10-14 days may be helpful.

1.21 LIV or greater

Positive - Probable presence of antibody to B. burgdorferi detected.

Borrelia burgdorferi Antibody, IgG by Immunoblot (CSF)

Effective August 15, 2011

Negative

Borrelia burgdorferi Antibody, IgM by Immunoblot (CSF)

Effective August 15, 2011

Negative

Critical Value

N/A

Interpretation

The detection of antibodies to B. 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.

If Reflexed to Borrelia burgdorferi Antibody, IgG by Immunoblot (CSF): For this assay, a positive result is reported when any 5 or more of the following 10 bands are present: 18, 23, 28, 30, 39, 41, 45, 58, 66, or 93 kDa. All other banding patterns are reported as negative.

If reflexed to Borrelia burgdorferi Antibody, IgM by Immunoblot (CSF): For this assay, a positive result is reported when any 2 or more of the following bands are present: 23, 39, or 41 kDa. All other banding patterns are reported as negative.

Current CDC recommendations for the serologic diagnosis of Lyme disease are to screen with a polyvalent ELISA test and confirm equivocal and positive results with immunoblot. Both IgM and IgG immunoblots should be performed on samples less than 4 weeks after appearance of erythema migrans. Only IgG immunoblot should be performed on samples greater than 4 weeks after the disease onset. IgM immunoblot in the chronic stage is not recommended and does not aid in the diagnosis of neuroborreliosis or chronic Lyme disease. Please submit requests for appropriate immunoblot testing within 10 days.

Rejection Criteria

Contaminated, heat-inactivated, or hemolyzed specimens.

Specimen Availability for Add-on Testing

2 Days

Specimen Stability

Refrigerated (preferred): 2 weeks
Ambient: 8 hours
Frozen: 1 year

Day(s) Performed

Sun – Sat

Performing Lab- Department

TUKHS-BH-Mail Outs

CPT Code

86618; if reflexed, add 86617 × 2

LOINC Code

6318-0
If reflexed to Borrelia burgdorferi Ab, IgG, IB (CSF), add: 13202-7
If reflexed to Borrelia burgdorferi Ab, IgM, IB (CSF), add: 13203-5

Test Alias

Lyme Disease CSF Abs Reflex Panel

Additional Information / Notes

If B. burgdorferi total antibodies by ELISA are 1.00 LIV or greater, then B. burgdorferi IgG antibody by immunoblot and IgM antibody by immunoblot will be added.