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Clinical Testing
Suggestions
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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 Lab: Unevx Laboratories, 1664 N. Virginia St., Reno, NV 89557, Tel: 775-682-8280, Fax: 775-682-8290 (Test Description Code: MYCP) Specimen Requirements: Contact laboratory for a specimen kit. 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. 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 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,
Scientists and physicians at the Institute for Molecular Medicine have been
working with veterinarians who have patients of various species with undiagnosed
illnesses, in some cases similar to their owners who have Chronic Fatigue
Syndrome (CFS), Fibromyalgia Syndrome (FMS), Gulf War Illness (GWI) or
Rheumatoid Arthritis (RA). We have determined that a connection exists between
the above chronic illnesses suffered by humans and chronic infections caused by
Mycoplasma, Chlamydia, Borrelia or other chronic infectious pathogens. For
example, Mycoplasmas are microscopic microorganisms similar to bacteria but
without a rigid cell wall. Some species of Mycoplasma or Chlamydia do not cause
human or animal diseases, but more recently several species have been shown to
cause or are a cofactor in disease, and when such microorganisms are found in
the blood, they should be treated just like any other bacterial blood infection.
The species of Mycoplasma that we have found in about 50% of CFS, 60% of FMS,
45% of GWI and 40% of RA patients and their pets cause systemic infections that
invade virtually every tissue in the body and can compromise the immune system,
permitting opportunistic infections by viruses, bacteria, fungi and yeast. Often
these patients have multiple chronic infections and their signs/ symptoms can be
quite complex, and each patient tends to have his or her own unique set of
problems.
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