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Protein S Antigen

CPT

85305; 85306

Test Details

Methodology

Total and free PS antigens are measured by latex immunoassay.

Result Turnaround Time

2 - 3 days

Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.

Related Documents

For more information, please view the literature below.

Test Includes

This test includes protein S, total; and protein S, free.

Use

This test is used for confirmation and characterization of protein S (PS) congenital deficiency.

Special Instructions

If the patient's hematocrit exceeds 55%, the volume of citrate in the collection tube must be adjusted. Refer to Coagulation Collection Procedures for directions.

Limitations

The presence of rheumatoid factor at a level greater than 300 IU/mL may lead to an over-estimation of the total protein S level.8
The presence of anti-rabbit antibodies in certain subjects leads to aberrant results.8

Custom Additional Information

See Protein S Deficiency Profile [117754] for more clinical information.

Specimen Requirements

Specimen

Plasma, frozen

Volume

1 mL

Container

Blue-top (sodium citrate) tube

Collection Instructions

Citrated plasma samples should be collected by double centrifugation. Blood should be collected in a blue-top tube containing 3.2% buffered sodium citrate.1 Evacuated collection tubes must be filled to completion to ensure a proper blood to anticoagulant ratio.2,3 The sample should be mixed immediately by gentle inversion at least six times to ensure adequate mixing of the anticoagulant with the blood. A discard tube is not required prior to collection of coagulation samples, except when using a winged blood collection device (i.e., "butterfly"), in which case a discard tube should be used.4,5 When noncitrate tubes are collected for other tests, collect sterile and nonadditive (red-top) tubes prior to citrate (blue-top) tubes. Any tube containing an alternate anticoagulant should be collected after the blue-top tube. Gel-barrier tubes and serum tubes with clot initiators should also be collected after the citrate tubes. Centrifuge for 10 minutes and carefully remove 2/3 of the plasma using a plastic transfer pipette, being careful not to disturb the cells. Deliver to a plastic transport tube, cap, and recentrifuge for 10 minutes. Use a second plastic pipette to remove the plasma, staying clear of the platelets at the bottom of the tube. Transfer the plasma into a Labcorp PP transpak frozen purple tube with screw cap (Labcorp No. 49482). Freeze immediately and maintain frozen until tested.

Please print and use the Volume Guide for Coagulation Testing to ensure proper draw volume.

Stability Requirements

TemperaturePeriod
Frozen28 days
Freeze/thaw cyclesStable x3

Reference Range

Protein S Antigen6-8
AgeRange
0 to 6 m12–60%
>6 m60–140%

 

Total: In newborns, total PS levels are lower than in adults (12% to 60%). Levels gradually reach adult ranges by six months of age.6

Storage Instructions

Freeze.

Patient Preparation

Avoid warfarin (Coumadin®) therapy for two weeks and heparin therapy for two days prior to the test. Do not draw from an arm with a heparin lock or heparinized catheter.

Causes for Rejection

Gross hemolysis; clotted specimen; frozen specimen thawed in transit; improper labeling

References

Gupta A, Tun AM, Gupta K, Tuma F. Protein S Deficiency. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan. 2022 Dec 5. PubMed 31335064

Moore GW. Thrombophilia Screening: Not So Straightforward. Semin Thromb Hemost. 2024 Nov;50(8):1131-1152. PubMed 38733983

Footnotes

1. Adcock DM, Kressin DC, Marlar RA. Effect of 3.2% vs 3.8% sodium citrate concentration on routine coagulation testing. Am J Clin Pathol.1997;107(1):105-110. 8980376
2. Reneke J, Etzell J, Leslie S, et al. Prolonged prothrombin time and activated partial thromboplastin time due to underfilled specimen tubes with 109 mmol/L (3.2%) citrate anticoagulant. Am J Clin Pathol. 1998;109(6):754-757.9620035
3. Clinical Laboratory Standards Institute (CLSI). Collection, Transport, and Processing of Blood Specimens for Testing Plasma-Based Coagulation Assays. 6th ed. CLSI guideline H21. Clinical and Laboratory Standards Institute; 2024.
4. Gottfried EL, Adachi MM. Prothrombin time and activated partial thromboplastin time can be performed on the first tube. Am J Clin Pathol. 1997;107(6):681-683. 9169665
5. McGlasson DL, More L, Best HA, et al. Drawing specimens for coagulation testing: Is a second tube necessary? Clin Lab Sci. 1999;12(3):137-139. 10539100
6. Van Cott EM, Laposata M. Coagulation. In Jacobs DS, DeMott WR, Oxley DK, eds. Laboratory Test Handbook With Key Word Index. Hudson, Ohio: Lexi-Comp; 2001: 327-358.
7. Liberti G, Bertina RM, Rosendaal FR. Hormonal state rather than age influences cut-off values of protein S: reevaluation of the thrombotic risk associated with protein S deficiency. Thromb Haemost. 1999 Sep;82(3):1093-1096. PubMed 10494769
8. STA® - LIATEST® PROTEIN S Microlatex Particle-Mediated Immunoassay for Total Protein S Instructions For Use (IFU) [package insert]. November 2015.

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
164517 Protein S-Antigen 87557-5 164518 Protein S, Total % 27823-4
164517 Protein S-Antigen 87557-5 164519 Protein S, Free % 27821-8
Order Code164517
Order Code NameProtein S-Antigen
Order Loinc87557-5
Result Code164518
Result Code NameProtein S, Total
UofM%
Result LOINC27823-4
Order Code164517
Order Code NameProtein S-Antigen
Order Loinc87557-5
Result Code164519
Result Code NameProtein S, Free
UofM%
Result LOINC27821-8