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Test Code Billings Clinic: 5371 Mayo: LNBAI Lyme Central Nervous System Infection IgG, Antibody Index, Spinal Fluid

Reporting Name

Lyme CNS Infection IgG, Ab Index

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Useful For

Providing antibody index information to aid in the diagnosis of neuroinvasive Lyme disease or neuroborreliosis due to Borrelia species associated with Lyme disease (eg, Borrelia burgdorferi, Borrelia garinii, Borrelia afzelli)

Method Name

Only orderable as part of a profile. For more information see LNBAB / Lyme Central Nervous System Infection IgG with Antibody Index Reflex, Serum and Spinal Fluid.

 

Enzyme-Linked Immunosorbent Assay (ELISA)


Specimen Required


Only orderable as part of a profile. For more information see LNBAB / Lyme Central Nervous System Infection IgG with Antibody Index Reflex, Serum and Spinal Fluid.

 

Specimen Type: Spinal fluid

Container/Tube: Sterile vial

Specimen Volume: 1.2 mL

Collection Instructions:

1. A spinal fluid (CSF) sample of 1.2 mL needs to be collected within 24 hours of the serum specimen, preferably at the same time.

2. Label vial as spinal fluid or CSF.

3. CSF aliquot should be from the second, third, or fourth CSF vial collected during the lumbar puncture.

Do not submit CSF from the first vial due to the possibility of blood contamination, which will cause specimen rejection.

4. Band specimens together.

 

Specimen Type: Serum

Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial

Specimen Volume:  1.2 mL

Collection Instructions:

1. A serum sample of 1.2 mL needs to be collected within 24 hours of the spinal fluid specimen, preferably at the same time.

2. Centrifuge and aliquot serum into a plastic vial.

3. Label as serum.

4. Band specimens together.


Specimen Type

CSF

Specimen Minimum Volume

See Specimen Required

Specimen Stability Information

Specimen Type Temperature Time Special Container
CSF Refrigerated (preferred) 11 days
  Frozen  35 days

Reject Due To

Gross hemolysis Reject
Gross lipemia Reject
CSF contaminated with blood Reject

Reference Values

Only orderable as part of a profile. For more information see LNBAB / Lyme Central Nervous System Infection IgG with Antibody Index Reflex, Serum and Spinal Fluid.

 

0.6-1.2

Interpretation

Negative (Lyme CNS antibody index [AI] 0.6 to <1.3): Results indicate lack of intrathecal antibody synthesis to Lyme disease associated Borrelia species. This suggests the absence of neuroinvasive Lyme disease. The initial screen reactive result may be due to anti-Borrelia species antibodies present in the cerebrospinal fluid (CSF) due to increased permeability of the blood-brain barrier or transient introduction during lumbar puncture.

 

Equivocal (Lyme CNS AI 1.3 to 1.5): Low level of intrathecal antibody synthesis to Lyme disease associated Borrelia species detected. Results should be correlated with exposure history and clinical presentation to establish a diagnosis of neuroinvasive Lyme disease.

 

Positive (Lyme CNS AI >1.5): Results indicate the presence of intrathecal antibody synthesis to Lyme disease associated Borrelia species, suggesting neuroinvasive Lyme disease. Results should be correlated with exposure history and clinical presentation to establish the diagnosis.

 

Invalid (Lyme CNS AI <0.6): Result is due to abnormally elevated total IgG levels in CSF. This may be due to passive diffusion through the blood-brain barrier or contamination of the CSF with blood during a traumatic lumbar puncture. Repeat testing may be considered

Day(s) Performed

Monday, Wednesday, Friday

Report Available

Same day/1 to 4 days

Test 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

86618 x 2

82040

82042

82784 x 2

LOINC Code Information

Test ID Test Order Name Order LOINC Value
LNBAI Lyme CNS Infection IgG, Ab Index 92812-7

 

Result ID Test Result Name Result LOINC Value
LNB3 Lyme CNS IgG Ab Index Value 92811-9
LNB4 Lyme CNS IgG Ab Index Interp 69048-7