Melissa Kaplan's
Lyme Disease
Part of the Anapsid.org Chronic Neuroimmune Diseases Information Resources for CFS, FM, MCS, Lyme Disease, Thyroid, and more...
Last updated January 1, 2014

Note:
This panel is referred to as the "Stricker Panel" because Dr. Stricker and a couple of other doctors decided to look at this particular collection of data to see if they could see any patterns between the test results and how their patients were feeling and responding (or not) therapeutically. The panel could just have easily been called the NK CD-57 Panel, or George. It is not a proprietary-to Stricker, or proprietary-to-LabCorp test or set of tests. For ease in communication, it was just simpler for people to refer to it as "the Stricker Panel" than "that WBC, Lymphocytes, % T cells (CD3+), % NK Subset (CD57+/CD8), % CD8+/CD57+, Total Lymphocytes, Total T cells (CD3), Total CD8+/CD57+, and Total NK subset (CD57+/CD8) panel."

Another test gaining popularity amongst physicians treating Lyme patients is one of the antigen tests, CD-57. For information on the use of the test Lyme patients, please read Long-Term Decrease in CD-57 Lymphocyte Subset in Patients with Chronic Lyme by Stricker, Burrascano and Winger. Your physician can order the Stricker NK Panel CD-57 from Labcorp (who recently purchased IDL, the lab that developed this particular test). If your physician or lab has questions about this test, they can call LabCorp at 510-635-4555. As of this writing, this test was not yet on Labcorp's website.

• If you live near a LabCorp collection site, bring a lab slip from your physician. The physician needs to indicate the diagnosis (ICD-9 for Lyme: 088.81), the test procedure code AND description (Test ID# 32103-5, Stricker NK Panel CD-57).

• Not all LabCorp facilities are familiar with this test panel, so the collection site personnel may have to call headquarters to find out the collection and shipping procedure. Check the LabCorp site for a collection site near you.

• If your doctor's office draws blood for tests, they will need to complete the LabCorp form as described above (diagnosis, test ID number, test name). They will need to fill 1 lavender top and 1 yellow top. The blood does not need to be spun, nor refrigerated. It does need to be shipped so that LabCorp receives it within 24 hours. That means blood draws need to be done on Monday-Thursdays, not on Fridays.

• If push comes to shove, LabCorp can send out a test kit for this test, but the kit currently (as of 9/8/2003) does not have the above instructions in it.

• Make sure that the date and time the blood was collected is written on the form.

• If you want a copy of the test results for your files, you can enter your name and your mailing address, or email address, or fax number, in the shaded field provided on the lab form, just above the fields for the patient's name, address, etc. This holds true for any lab tests ordered from LabCorp.

This test is not meant to replace the IGeneX Western Blot. This series of tests looks at various other immune factors that Dr. Stricker and others are looking at in conjunction with relapsing and remitting chronic neuroborreliosis.

The tests included in the Stricker NK Panel CD-57 are:

Just to ensure that nothing is ever cut-and-dried with Lyme, most patients who are in a Lyme relapse (flare) will have a very low NK cell count, while those who are feeling somewhat better will have normal-high NK counts.

And then there are people like me, who had a zero (that is, 0) NK count in while feeling significantly better (all things being relative) than some friends in severe flare, who had normal-high NK counts.

While many Lyme patients are getting this test, it is not a Lyme--or any sort of TBD--test. It is a look at some aspects of the immune system's ability to fight off infection, and so a general immune deficiency ICD code is generall used on the test request form, such as 279.3 - Unspecified immunity deficiency.

No LabCorp In Your Area? That Shouldn't Be A Problem...
All general path labs should be already have these individual tests protocols in their lab - meaning, any general pathology lab should be able to do them. It is just a matter of any ordering physician's staff person looking them up in their usual clinical lab's test listing book all labs give all doctors offices that order lab tests from them. Once the test is found in the book, the staffer will find what their lab's test number is for the individual tests.

For example: Dr. Zzsrtzszo in East Podunk uses Acme Lab for his general labs. All Dr. Zzsrtzszo needs to do is look up those tests in Acme's book, write down the lab's test code numbers--and proper ICD-9 diagnosis code--on Acme's lab test request form.

If Dr. Zzsrtzszo's office has a venipuncturist on staff who usually draws blood from patients needing such testing, the venipuncturist can draw the blood and send it off, along with the usual completed Acme lab test request form, with the afternoon courier. If there is no staff venipuncturist is available, the usual completed Acme Labs test request form is handed to the patient for the patient to take with them to their favorite Acme Lab blood draw center.

The requested blood tests are performed by Acme Labs, and as they always do, the results are sent to Dr. Zzsrtzszo. When the patient next sees Dr. Zzsrtzszo, she or he can get a copy of the test results from Dr. Zzsrtzszo. If the patient wants, the patient can make another copy, obliterate the personally identifying information, and send that altered copy to Dr. Stricker.

A Last Important Note:
One thing that probably needs to be said is that these tests, while they may be useful in supporting or adding another layer of data to the picture of immune dysfunction, are not definitively diagnostic of anything.

The tests listed above may or may not be useful to the patient and the ordering physician in looking into other areas of supportive treatment. If one's insurance carrier or Medicare pays, great. If not, the patient has to decide whether having the panel done is going to be interesting or useful enough (for example, in helping to support their claim of being too sick to work; in finding out about or tracking NK cell counts, etc.) to pay for the testing themselves. If money is tight, as it is for most of us, then, since this is not a diagnostic test panel, don't have it done if what you are looking for is a diagnosis or confirmation of a different diagnostic test.

Another Important Note:
Your insurance may or may not cover this group of tests. Medicare may or may not cover this group of tests. You may be requested to sign an Medicare Advance Beneficiary Notice (ABN) which states that you understand the test may not be covered by Medicare, and if Medicare does not pay it, you will have to pay the lab in full (in the neighborhood of $150). If you chose not to sign ABN, you are choosing not to have the test. If you are not presented with an ABN to sign, and Medicare does not pay for the test, you will not be required to pay the lab.

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