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Test Code LUPUSM Lupus Anticoagulant Profile

Additional Codes

 

 

MAYO Test ID

LUPPR

EPIC Test ID

LAB478

 

Reporting Name

Lupus Anticoag Prof

Useful For

Confirming or excluding presence of lupus anticoagulant (LAC) distinguishing LAC from specific coagulation factor inhibitors and nonspecific inhibitors

 

Investigation of a prolonged activated thromboplastin time, especially when combined with other coagulation studies

Profile Information

Test ID Reporting Name Available Separately Always Performed
PTC Prothrombin Time (PT), P Yes, (order PTTP) Yes
APTTB Activated Partial Thrombopl Time, P Yes, (order APTTP) Yes
DRVT Dilute Russells Viper Venom Time, P Yes, (Order DRVTI) Yes
CCC1 Interpretation No Yes

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
DIRM D-Dimer, P Yes, (order #9290) No
IBETH Bethesda Units No No
F8IS Coag Factor VIII Assay Inhib Scrn,P No No
FACTV Coag Factor V Assay, P Yes No
F_7 Coag Factor VII Assay, P Yes No
TT Thrombin Time (Bovine), P Yes No
F_9 Coag Factor IX Assay, P Yes No
F_10 Coag Factor X Assay, P Yes No
F_11 Coag Factor XI Assay, P Yes No
F_12 Coag Factor XII Assay, P Yes No
F8A Coag Factor VIII Activity Assay, P Yes No
RPTL Reptilase Time, P Yes No
F_2 Coag Factor II Assay, P Yes No
FIBC Fibrinogen, P Yes, (order #8484) No
SFM Soluble Fibrin Monomer No No
PNP Platelet Neutralization Procedure No No
PTMX PT Mix 1:1 No No
APTTM APTT Mix 1:1 No No
DRVTM DRVVT Mix No No
DRVTC DRVVT Confirmation No No
CCC2 Special Coagulation Interpretation No No
STLA Staclot LA, P No No

Testing Algorithm

Initial testing includes: prothrombin time (PT), activated partial thromboplastin time (APTT), and dilute Russell's viper venom time (DRVVT).

If the PT, APTT, and DRVVT are normal, a computer-generated interpretive comment indicating no evidence of a lupus anticoagulant will be provided.

If PT is ≥14 seconds, PT mix will be performed.

If APTT is >36 seconds, APTT mix will be performed.

If APTT mix is >36 seconds with no evidence of heparin in sample, platelet neutralization procedure (PNP) will be performed.

If DRVVT ratio is ≥1.2, DRVVT mix and DRVVT confirmation will be performed.

If PT, APTT, or DRVVT are prolonged, thrombin time (TT) will be performed.

If TT is >23 seconds, reptilase will be performed.

If appropriate, coagulation factor assays, fibrinogen, D-dimer, Staclot LA, and soluble fibrin monomer will be performed to clarify a significant abnormality in the screening clotting times.

If factor VIII result is <55%, the factor VIII inhibitor screen may be performed along with the Bethesda titering assay, if indicated.

If any test results are abnormal, all results will be reviewed by a coagulation consultant and a Special Coagulation Consultant Interpretation will be provided.

 

See Lupus Anticoagulant Profile Testing Algorithm in Special Instructions.

Method Name

PTC, PTMX, APTTB, DRVT, TT, RPTL, DRVTM, DRVTC, APTTM, STLA: Clot-Based Assay

DIRM: Automated Latex Immunoassay (LIA)

PNP: Activated Partial Thromboplastin Time (APTT) Mixing Test

F_2, FACTV, F_7, F_10, IBETH, F8IS: Prothrombin Clot-Based Assay

F8A, F_9, F_11, F_12: Activated Partial Thromboplastin Clot-Based Assay

FIBC: Clauss Methodology

SFM: Immunoturbidimetric

Performing Laboratory

Mayo Medical Laboratories in Rochester

Specimen Type

Plasma Na Cit


Specimen Required


See Coagulation Studies in Special Instructions.

 

Specimen Type: Platelet-poor plasma

Collection Container/Tube: Light-blue top (citrate)

Submission Container/Tube: Plastic vials

Specimen Volume: 5 mL in 5 plastic vials each containing 1 mL

Collection Instructions:

1. Spin down, remove plasma, and spin plasma again.

2. Freeze specimens immediately at ≤-40 degrees C, if possible.

3. Send specimens in the same shipping container.

Additional Information:

1. Double-centrifuged specimen is critical for accurate results as platelet contamination may cause spurious results.

2. If priority specimen, mark request form, give reason, and request a call-back.

3. Each coagulation assay requested should have its own vial.

4. If multiple coagulation profiles are ordered, each profile must be on a separate order.

5. Patient should not be receiving Coumadin or heparin.


Specimen Minimum Volume

4 mL in 4 plastic vials each containing 1 mL

Specimen Stability Information

Specimen Type Temperature Time
Plasma Na Cit Frozen 14 days

Reject Due To

Hemolysis

Mild OK; Gross reject

Lipemia

Mild OK; Gross reject

Icterus

Mild OK; Gross reject

Other

NA

Reference Values

PROTHROMBIN TIME (PT)

10.3-12.8 seconds

 

INR

0.9-1.2

The INR is used only for patients on stable oral anticoagulant therapy. It makes no significant contribution to the diagnosis or treatment of patients whose PT is prolonged for other reasons.

 

ACTIVATED PARTIAL THROMBOPLASTIN TIME (APTT)

Adults: 26-36 seconds

The normal full-term newborn APTT may be up to 35% longer than in adults and even longer (up to twice the adult upper limit) in healthy premature infants. Typically, the APTT is in the adult reference range by age 3 months in healthy full-term infants and by age 6 months in healthy premature infants (30-60 weeks gestation)*.

26-36 seconds (>3-6 months)

*See Pediatric Hemostasis References in Coagulation Studies in Special Instructions.

 

DILUTE RUSSELL'S VIPER VENOM TIME

<1.2

Day(s) and Time(s) Performed

Monday through Friday

CPT Code Information

85610-PT

85613-DRVVT

85730-APTT

85210-Factor II (if appropriate)

85220-Factor V (if appropriate)

85230-Factor VII (if appropriate)

85240-Factor VIII (if appropriate)

85250-Factor IX (if appropriate)

85260-Factor X (if appropriate)

85270-Factor XI (if appropriate)

85280-Factor XII (if appropriate)

85335-Bethesda units (if appropriate)

85335-Factor VIII inhibitor screen (if appropriate)

85366-Soluble fibrin monomer (if appropriate)

85379-D-dimer (if appropriate)

85384-Fibrinogen (if appropriate)

85390-26-Special coagulation interpretation (if appropriate)

85597-Platelet neutralization for lupus inhibitor (if appropriate)

85598-Staclot LA (if appropriate)

85611-PT mix 1:1 (if appropriate)

85613-DRVVT mix (if appropriate)

85613-DRVVT confirmation (if appropriate)

85635-Reptilase time (if appropriate)

85670-Thrombin time (if appropriate)

85732-APTT mix 1:1 (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
LUPPR Lupus Anticoag Prof 75881-3

 

Result ID Test Result Name Result LOINC Value
APTTB Activated Partial Thrombopl Time, P 14979-9
7525 Interpretation 69049-5
RVVR DRVVT Screen Ratio 15359-3
PR_TI Prothrombin Time (PT), P 5902-2
INR2 INR 6301-6
7769 Reviewed by: No LOINC Needed

Test Classification

This test was developed and its performance characteristics determined by Laboratory Medicine and Pathology, Mayo Clinic. This test has not been cleared or approved by the U.S. Food and Drug Administration.

Forms

1. Coagulation Patient Information (T675)

2. If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:

General Request Form (T239) (http://www.mayomedicallaboratories.com/it-mmfiles/general-request-form.pdf)

Coagulation Test Request Form (T753) (http://www.mayomedicallaboratories.com/it-mmfiles/coagulation-test-request-form.pdf)