- ANTIPHOSPHOLIPID SYNDROME REFLEXIVE PANEL
- Also known as: F269, APS, CLA, LUPUS ANTICOAGULANT, LUPUS INHIBITOR, 7079Orderable Code: F269Test Contains (LOINC): CARDIOLIPIN AB-IGG (3181-5), CARDIOLIPIN AB-IGM (8067-1), B2 GLYCOPROTEIN-1 IGG (44448-9), B2 GLYCOPROTEIN-1 IGM (44449-7), PROTHROMBIN TIME (5902-2), INR (6301-6), PARTIAL THROMBOPLASTIN TIME (34571-0), DRVV SCREEN (6303-2)***Others are REFLEXED, as needed:***
1:1 PTT MIXING (75510-8)
THROMBIN TIME (3243-3)
PTT HEPARIN NEUT (52123-7)
DRVVT SCREEN RATIO (15359-3)
1:1 DRVVT SCREEN MIX (75513-2)
DRVV CONFIRM (57838-5)
DRVVT CONFIRM RATIO (50410-0)
DRVVT NORMALIZE RATIO (50410-0)
HEX PHOSP NEUT DELTA (3282-1)
-If PT, PTT and DRVV screening tests along with IGG/IGM antibodies are normal, interpretive comment will be provided.
-If any test results are abnormal, the results will be reviewed by a pathologist (coagulation consultant) with an interpretation provided.
CPT code 85390-26 will apply.Sample Type: Citrated Platelet Poor Plasma (PPP), see below for instructionsPreferred Container: Sodium Citrate (Blue Top, 3.2%) TubeSample Volume: 6-1mL Aliquots of Platelet Poor PlasmaHandling Instructions
Specimen Instructions for Platelet Poor Plasma (PPP):
1. Draw 6 blue top tubes (3.2% sodium citrate), properly filled, as the appropriate ratio of blood to anticoagulant is critical to testing. Fill a light blue top tube as far as vacuum will allow and mix by gentle inversion five to six times. The exact ratio of 1 part sodium citrate to 9 parts blood must be maintained.
2. Patients who have hematocrit values above 55% should have the anticoagulant adjusted to maintain the 1 to 9 ratio. For further instructions on the collection of platelet-poor plasma for patients with hematocrit value of >55%, please see specimen collection manual on AEL website.
3. Spin sample to obtain platelet poor plasma (PPP) 2000-2500 x g for 15 minutes(or per centrifuge manufacturer’s collection instructions)
4. Aliquot approximately 3/4 of plasma from the top of new tubes, being careful not to touch the buffy coat.
5. Spin again according to specifications above and aliquot (again avoiding the buffy coat) into 6 plastic vials, each containing at least 1 ml of platelet poor plasma (PPP).
6. Immediately freeze aliquots. Do not thaw and refreeze.
7. The specimens must be separated and frozen within 4 hours of collection.
8. The double spin procedure described above ensures that the plasma is platelet free (<10x10x9/L). Test results are a direct reflection of sample integrity.Client Transport Temperature: Platelet Poor Plasma (PPP): Critical FrozenSpecimen Stability: Frozen: 2 MonthsUnsuitable Specimen: Platelet Poor Plasma: Thawed
Samples from patients with anticoagulants (heparin, warfarin, DOACs, etc.) may render unreliable results for clot-based testing.Frequency: Monday, ThursdayExpected Turn Around: 4 DaysResponsible Dept: Coagulation and ImmunologyCPT: 85610,85613,85730, 86147 x2, 86146 x2; If reflexed, additional CPT codes may apply; 85670, 85635, 85730-additional, 85525, 85613-additional x2, 85598, Pathologist Consult 85390-26Methodology: See individual test setsADDITIONAL INFORMATIONSubmission of anticoagulant use will assist in interpretation. Anticoagulants Code :Description ACOVA: Acova (argatroban) ANGIOMAX: Angiomax (bivalirudin) COUMADIN: Coumadin (warfarin) ELIQUIS: Eliquis (apixaban) HEP-SC: Heparin (SC) HEP-UFH: Heparin (UFH) LMWH: LMWH (e.g. Lovenox) NONE: None (no known anticoagulant) OTHER: Other – PRADAXA: Pradaxa (dabigatran) XARELTO: Xarelto (rivaroxaban)Notes: When multiple tests are ordered, submit separate tubes for this test.