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Test Code CSF Lyme Lyme Disease Serology, Spinal Fluid

Reporting Name

Lyme Disease Serology, CSF
Seattle Children's Hospital Note:

Clinical System Name: CSF Lyme Disease Ab-Reflex to Immunoblot

Useful For

Aiding in the diagnosis of Lyme neuroborreliosis

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
CLYWB Lyme Disease Ab, Immunoblot, CSF Yes No

Testing Algorithm

If Lyme disease serology is positive, then immunoblot testing will be performed at an additional charge.


See Acute Tick-Borne Disease Testing Algorithm in Special Instructions.

Performing Laboratory

Mayo Medical Laboratories in Rochester

Specimen Type


Specimen Required

Collection Container/Tube: Sterile vial

Submission Container/Tube: Plastic vial

Specimen Volume: 1 mL

Additional Information: This test is not available for specimens originating in New York.

Specimen Minimum Volume

0.5 mL

Specimen Stability Information

Specimen Type Temperature Time
CSF Refrigerated (preferred) 14 days
  Frozen  14 days

Reference Values


Reference values apply to all ages.

Day(s) and Time(s) Performed

Monday through Friday; 10 a.m.

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information

86618-Lyme disease serology

86617 x 2-Lyme blot (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
CLYME Lyme Disease Serology, CSF 16475-6


Result ID Test Result Name Result LOINC Value
CLYME Lyme Disease Serology, CSF 16475-6

Method Description

This Borrelia burgdorferi (Lyme) assay is based on a synthetic peptide antigen (C6 peptide) in microwell enzyme-linked immunosorbent assay (ELISA) format. The antigen is derived from the vlsE protein of Borrelia burgdorferi. In the assay procedure, diluted cerebrospinal fluid specimens are added and incubated in wells of an antigen-coated microwell plate. Antibodies specific to the C6 peptide in the specimen are bound by the immobilized antigen, and unbound antibodies are removed by wash steps. The bound antibodies are detected by addition of a horseradish peroxidase-conjugated goat antihuman IgG/IgM conjugate. After removal of excess conjugate by further wash steps, a chromogenic peroxidase substrate containing tetramethylbenzidine is added. A blue-green product is produced in wells where antibodies have been bound to the antigen. The color development reaction is quenched by addition of dilute sulfuric acid, after which optical absorbance at 450 nm is measured in each well using an ELISA plate reader.(Package insert: Immunetics C6 B. burgdorferi [Lyme] ELISA Kit. Immunetics, Boston, MA;2006; Liang FT, Steere AC, Marques AR, et al: Sensitive and specific serodiagnosis of Lyme disease by enzyme-linked immunosorbent assay with a peptide based on an immunodominant conserved region of Borrelia burgdorferi vlsE. J Clin Microbiol 1999;37[12]:3990-3996)

Reject Due To


Mild OK; Gross OK


Mild OK; Gross OK





Method Name

Enzyme-Linked Immunosorbent Assay (ELISA)