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20 mars 2012 2 20 /03 /mars /2012 07:28
Clinical Testing Suggestions For chronic illnesses (CFS, FMS, RA, Lupus, neurodegenerative diseases, among other illnesses) that could have an infectious component, The Institute for Molecular Medicine suggests the following lab tests (codes are CPT codes or test description/ordering codes): 1. Mycoplasma Test Panel (CPT: 87581)—Mycoplasma species tested by PCR. This is a Mycoplasma test on the 3 most common species of Mycoplasma (M. pneumoniae, M. ferementans, M. hominis). Individual tests species tests can also be ordered (M. pneumoniae, M. ferementans or M. hominis). Justification: Almost 60% of CFS/FMS and 50% of Rheumatoid Arthritis (RA) and 50% other autoimmune patients have one or more intracellular, systemic mycoplasmal infections similar to those found in a variety of chronic illnesses [Nicolson et al. Mycoplasmal infections in chronic illnesses: Fibromyalgia and Chronic Fatigue Syndromes, Gulf War Illness, HIV-AIDS and Rheumatoid Arthritis. Medical Sentinel 1999; 5: 172-176]. Ultrasensitive and ultraspecific mycoplasma tests can only be done by a small number of labs. Recommended Labs: Unevx Laboratories, 1664 N. Virginia St., Reno, NV 89557, Tel: 775-682-8280, Fax: 775-682-8290 (Test Description Code: MYCP) Spiro Stat Technologies, 1004 Garfield Dr., Bld 340, Lubbock, TX 79416; Tel: 806-885-2929, Fax: 806- 885-2933, Specimen Requirements: Contact laboratory for a specimen kit. For Unevx, the blood is collected in a Lavender Top EDTA tube, mixed and shipped (same day) in an insulated container overnight air courier to arrive within 24 hours. For Spiro Stat, the blood is collected in 2 Purple Top EDTA tubes. 2. Chlamydia pneumoniae Test (CPT: 87486)—Chlamydia pneumoniae tested by PCR. Justification: Many CFS, FMS, MS, RA and other patients have this systemic infection along with viral infection(s). We were among the few labs that developed the molecular tests that are now done for this type of infection. Recommended Lab: Unevx Laboratories, 1664 N. Virginia St., Reno, NV 89557, Tel: 775-682-8280, Fax: 775-682-8290 (Test Description Code: CHLP) Specimen Requirements: Contact laboratory for a specimen kit. The blood is collected in (1) Lavender Top EDTA tube and (1) Red Top Serum Separator Tube (separated), and shipped (same day) in an insulated container overnight air courier to arrive within 24 hours. 3. Lyme Borrelia burgdorferi Test (CPT: 86617)—Borrelia burgdorferi (Lyme Disease) by Western Blot analysis. Justification: Many CFS, FMS and RA patients have this systemic infection (diagnosed as Lyme Disease) along with other co-infection(s) (Nicolson et al. Chronic Fatigue Syndrome patients subsequently diagnosed with Lyme Disease Borrelia burgdorferi: evidence for Mycoplasma species co-infections. J Chronic Fatigue Syndr 2008; 14(4):5-17. Recommended Lab: IGeneX Laboratories of Palo Alto, CA (http://www.igenex.com/). Specimen Requirements: Contact laboratory for a specimen kit. Collect in Red Top Tube, separate, and send in clear tube. Store in Refrigerator until shipment. Ship within one day of collection at Room Temperature. 4. HHV-6 Test (CPT: 87532)—Human herpes virus 6 (HHV-6) test by PCR. Justification: Many CFS and some FMS patients have this systemic viral infection, and it should be tested for in any autoimmune illness (Nicolson et al. Multiple co-infections (Mycoplasma, Chlamydia, Human Herpesvirus-6) in blood of chronic fatigue syndrome patients: association with signs and symptoms. Acta Pathol Microbiol Immunol Scand 2003; 111: 557-566). Recommended Lab: Unevx Laboratories, 1664 N. Virginia St., Reno, NV 89557, Tel: 775-682-8280, Fax: 775-682-8290 (Test Description Code: HHVP) Specimen Requirements: Contact laboratory for a specimen kit. The blood is collected in (1) Lavender Top EDTA tube and (1) Red Top Serum Separator Tube (separated), and shipped (same day) in an insulated container overnight in any autoimmune illness (Nicolson et al. Multiple co-infections (Mycoplasma, Chlamydia, Human Herpesvirus-6) in blood of chronic fatigue syndrome patients: association with signs and symptoms. Acta Pathol Microbiol Immunol Scand 2003; 111: 557-566). Recommended Lab: Unevx Laboratories, 1664 N. Virginia St., Reno, NV 89557, Tel: 775-682-8280, Fax: 775-682-8290 (Test Description Code: HHVP) Specimen Requirements: Contact laboratory for a specimen kit. The blood is collected in (1) Lavender Top EDTA tube and (1) Red Top Serum Separator Tube (separated), and shipped (same day) in an insulated container overnight air courier to arrive within 24 hours. 5. CMV Test 07034 (CPT: 87496)—Cytomegalovirus (CMV) test by nested PCR. Justification: Many CFS and FMS patients have this systemic viral infection, and it should be tested for in any autoimmune illness. Recommended Lab: Unevx Laboratories, 1664 N. Virginia St., Reno, NV 89557, Tel: 775-682-8280, Fax: 775-682-8290 (Test Description Code: HHVP) Specimen Requirements: Contact laboratory for a specimen kit. The blood is collected in (1) Lavender Top EDTA tube and (1) Red Top Serum Separator Tube (separated), and shipped (same day) in an insulated container overnight air courier to arrive within 24 hours. Tests must be ordered by a physician, and tests must be pre-paid or pre-approved by an insurance carrier (private insurance or Medicare, Medicaid or Medical). The Institute for Molecular Medicine website is www.immed.org. On this site you will find publications and documents on CFS/ME, FMS, autoimmune diseases and other chronic illnesses. Prof. Garth Nicolson President & Chief Scientific Officer, The Institute for Molecular Medicine (www.immed.org)

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