Test Code Epic LAB2594 Lyme Disease, Molecular Detection, PCR, Varies
Additional Codes
SQ: LYMPCM
MAYO: LYMPV
Ordering Guidance
This assay does not detect Borrelia miyamotoi. If infection with this organism is suspected, order BMIPB / Borrelia miyamotoi Detection, PCR, Blood or BMIYC / Borrelia miyamotoi Detection, PCR, Spinal Fluid.
Necessary Information
Specimen source is required.
Specimen Required
Submit only 1 of the following specimens:
Specimen Type: Spinal fluid
Container/Tube: Sterile vial
Specimen Volume: 1 mL
Collection Instructions: Label specimen as spinal fluid.
Specimen Type: Synovial fluid
Container/Tube: Sterile vial
Specimen Volume: 1 mL
Collection Instructions: Label specimen as synovial fluid.
Specimen Type: Tissue (fresh only)
Sources: Skin or synovial biopsy
Container/Tube: Sterile container with normal saline
Specimen Volume: Approximately 4 mm(3)
Collection Instructions:
1. Submit only fresh tissue.
2. Skin biopsies:
a. Wash biopsy site with an antiseptic soap. Thoroughly rinse area with sterile water. Do not use alcohol or iodine preparations. A local anesthetic may be used.
b. Biopsy specimens are best taken by punch biopsy to include full thickness of dermis.
3. Label specimen with source of tissue.
Secondary ID
618310Useful For
Supporting the diagnosis of Lyme disease in conjunction with serologic testing
Specific indications including testing skin biopsies when a rash lesion is not characteristic of erythema migrans and testing synovial fluid or synovium to support the diagnosis of Lyme arthritis
This test should not be used to screen asymptomatic patients.
Testing Algorithm
The following algorithms are available:
Special Instructions
Method Name
Real-Time Polymerase Chain Reaction (PCR)/DNA Probe Hybridization
Reporting Name
Lyme Disease, PCR, VariesSpecimen Type
VariesSpecimen Minimum Volume
Spinal Fluid: 0.3 mL; Synovial Fluid: 0.5 mL; Tissue: See Specimen Required
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Varies | Refrigerated (preferred) | 7 days | |
Frozen | 7 days |
Reject Due To
All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.Reference Values
Negative
Reference values apply to all ages.
Method Description
Nucleic acid is extracted from clinical specimens using the automated MagNA Pure LC instrument system. The extract is then transferred to individual wells of a 96-well plate for amplification. The LightCycler is an automated instrument that amplifies and monitors the development of target nucleic acid (amplicon) after each cycle of polymerase chain reaction (PCR). The DNA target for PCR assay is the 283-base pairs plasminogen-binding protein gene (OppA2), which is present at a frequency of 1 copy per organism in all 4 confirmed pathogenic species of the Borrelia burgdorferi sensu lato genogroup (B burgdorferi sensu stricto, Borrelia afzelii, Borrelia garinii, and Borrelia mayonii). A specific base pair DNA target sequence is amplified by PCR. The detection of amplicon is based on fluorescence resonance energy transfer, which utilizes 1 hybridization probe with a donor fluorophore, fluorescein, at the 3' end, and a second hybridization probe with an acceptor fluorophore, LC-Red 610, at the 5' end. When the target amplicon is present, the LC-Red 610 emits a measurable and quantifiable light signal at a specific wavelength. Presence of the specific organism nucleic acid may be confirmed by performing a melting curve analysis of the amplicon. Using features of the melting curve analysis, the assay primers and specific hybridization probes are able to detect and differentiate B burgdorferi sensu stricto from B mayonii, B afzelii, and B garinii, although the melting curve analysis cannot differentiate between B afzelii and B garinii. Each assay run can be completed within 60 minutes.(Unpublished Mayo method)
Day(s) Performed
June through November: Monday through Saturday
December through May: Monday through Friday
Report Available
Same day/ 1 to 4 daysPerforming Laboratory
Mayo Clinic Laboratories in RochesterTest Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
87476
87798 x 2
87999 (if appropriate for government payers)
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
LYMPV | Lyme Disease, PCR, Varies | 94253-2 |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
LYMS | Specimen Source | 31208-2 |
618333 | B. burgdorferi PCR | 94250-8 |
618334 | B. mayonii PCR | 94251-6 |
618335 | B. garinii/B. afzelii PCR | 94252-4 |
618336 | Lyme CSF Comment | 59464-8 |
Forms
If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.