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LYMEP / PBORR-M
LYME DISEASE BY RAPID POLYMERASE CHAIN REACTION (PCR-FLUID)

Test Code LYMEP / PBORR-M 
Test LYME DISEASE BY RAPID POLYMERASE CHAIN REACTION (PCR-FLUID) 
Methodology Real-time Polymerase Chain Reaction (PCR)/DNA Probe
Hybridization
(PCR is utilized pursuant to a license agreement
with Roche Molecular Systems, Inc.) 
Description PCR testing of cerebral spinal fluid (CSF) is not clinically useful.
PCR testing of CSF is positive in only about one third of US patients with early neuroborreliosis, and it is even less sensitive in patients with late neurologic disease.

Urine is not a suitable sample for PCR testing at any
stage of Lyme disease.

Borrelia burgdorferi, the spirochete that causes Lyme disease, concentrates in collagen-rich connective tissues. The bloodborne phase is relatively brief and the concentration of spirochetes is quite low. In fact, PCR detects Borrelia DNA in the blood of fewer than half of patients in the early acute stage of disease when the erythema migrans rash is present.

By the time symptoms of Lyme disease have been present for a month or more, spirochetes can no longer be found in blood.

The utility of testing synovial fluid is not well established and should be considered only under special circumstances.

http://www.medscape.com/viewarticle/764501 

Specimen

SPINAL FLUID or SYNOVIAL FLUID
1.0 mL (minimum: 0.5 mL) of spinal fluid or 1.0 mL of synovial fluid. (GREEN-TOP [HEPARIN] TUBE IS NOT ACCEPTABLE.) Send specimen refrigerated in a screw-capped, sterile vial. Maintain sterility and forward promptly. Specimens grossly contaminated with blood may inhibit the PCR and produce false-negative results.


NOTE:
1. Indicate spinal fluid or synovial fluid on request form.
2. Label specimen appropriately (spinal fluid or synovial fluid). 

Reference Values Negative

Interpretation:
A positive result indicates the presence of DNA from Borrelia burgdorferi, B mayonii, B afzelli or B garinii, the main agents of Lyme disease.

A negative result indicates the absence of detectable target DNA in the specimen. Due to the clinical sensitivity limitations of the PCR assay, a negative result does not preclude the presence of the organism or active Lyme disease. 

Analytic Time 1 Day 
Day(s) Test Set Up Monday through Friday 
CPT Code(s) 87476  
87798 x2