Thrombotic Risk Profile II

CPT: 83090; 85300; 85303; 85306; 85307; 85420; 85613; 85705; 85732; 86146(x3); 86147(x3); 86148(x3)
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Test Includes

Activated protein C resistance (APCR); activated protein C with reflex to factor V; anticardiolipin antibodies, IgA, IgG, IgM, quantitative; antiphosphatidylserine, IgA, IgG, IgM; antithrombin activity; β2-glycoprotein I antibodies, IgA, IgG, IgM; dilute prothrombin time (dPT); dilute prothrombin time confirmation ratio; dilute Russell’s viper venom time (dRVVT); homocyst(e)ine, plasma; lupus anticoagulant reflex; lupus reflex interpretation; partial thromboplastin time (PTT), lupus anticoagulant (PTT-LA); plasminogen activity; protein C, functional; protein S, free


Special Instructions

If the Activated Protein C Resistance (APCR) [117763] result is <2.0, it will reflex to the Factor V Leiden Mutation Analysis [511154] at an additional charge.


Expected Turnaround Time

3 - 5 days


Related Documents

For more information, please view the literature below.

Procedures for Hemostasis and Thrombosis: A Clinical Test Compendium


Specimen Requirements


Specimen

Plasma, frozen, and serum, refrigerated, and whole blood or buccal swab kit (buccal swab collection kit contains instruction for the use of a buccal swab)


Volume

2 mL frozen sodium citrate plasma and 1 mL serum and 7 mL whole blood or buccal swab


Container

Blue-top (sodium citrate) tube, gel-barrier tube, lavender-top (EDTA) tube, yellow-top (ACD) tube, or Labcorp buccal swab kit


Collection

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 tubes. Gel-barrier tubes and serum tubes with clot initiators should also be collected after the citrate tubes. Centrifuge for 10 minutes and (using a plastic transfer pipette) carefully remove two-thirds of the plasma without disturbing the cells. Deliver to a plastic transfer 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). The specimen should be frozen immediately and maintained frozen until tested. To avoid delays in turnaround time when requesting multiple tests on frozen samples, please submit separate frozen specimens for each test requested.

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


Storage Instructions

Freeze plasma, refrigerate serum. Maintain whole blood and buccal swab kit at room temperature or refrigerate.


Patient Preparation

Do not draw from an arm with a heparin lock or heparinized catheter.


Test Details


Use

Evaluate for the presence of hereditary or acquired factors that may increase the risk for developing venous thrombosis


Methodology

See individual tests.


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 Jan;107(1):105-110.8980376
2. Reneke J, Etzell J, Leslie S, Ng VL, Gottfried EL. Prolonged prothrombin time and activated partial thromboplastin due to underfilled specimen tubes with 109 mmol/L (3.2%) citrate anticoagulant. Am J Clin Pathol. 1998 Jun;109(6):754-757.9620035
3. National Committee for Clinical Laboratory Standardization. Collection, Transport, and Processing of Blood Specimens for Coagulation Testing and General Performance of Coagulation Assays; Approved Guideline. 5th ed. Villanova, Pa: NCCLS; 2008. Document H21-A5:28(5).
4. Gottfried EL, Adachi MM. Prothrombin time and activated partial thromboplastin time can be performed on the first tube. Am J Clin Pathol. 1997 Jun;107(6):681-683.9169665
5. McGlasson DL, More L, Best HA, Norris WL, Doe RH, Ray H. Drawing specimens for coagulation testing: Is a second tube necessary? Clin Lab Sci. 1999 May-Jun;12(3):137-139.10539100

References

Alving BM. The antiphospholipid syndrome: Clinical presentation, diagnosis and patient management. In: Kitchens CS, Alving BM, Kessler CM, eds. Consultative Hemostasis and Thrombosis. Philadelphia, Pa. WB Saunders Co; 2002:181-196.
Schafer Al, Levine MN, Konkle BA, Kearon C. Thrombotic disorder: Diagnosis and treatment. Hematology Am Soc Hemataol Educ Program. 2003;520-539.14633797
Triplett DA. Thrombophilia. In: McClatachey KD, ed. Clinical Laboratory Medicine. 2nd ed. Philadelphia, Pa. Lippincott Williams and Wilkins; 2002:1033-1049.

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
117205 Thrombotic Risk Profile II 707009 Homocyst(e)ine umol/L 13965-9
117205 Thrombotic Risk Profile II 117714 Plasminogen % 5970-9
117205 Thrombotic Risk Profile II 015040 Antithrombin Activity % 27811-9
117205 Thrombotic Risk Profile II 117705 Protein C-Functional % 27819-2
117205 Thrombotic Risk Profile II 164519 Protein S, Free % 27821-8
117205 Thrombotic Risk Profile II 117763 Act.Prt.C Resist. ratio 13590-5
117205 Thrombotic Risk Profile II 117871 FVDNA TRACKING N/A
117205 Thrombotic Risk Profile II 117003 PTT-LA sec 34571-0
117205 Thrombotic Risk Profile II 117891 dRVVT sec 6303-2
117205 Thrombotic Risk Profile II 117893 Lupus Reflex Interpretation 75514-0
117205 Thrombotic Risk Profile II 005201 Dilute Prothrombin Time(dPT) sec 75508-2
117205 Thrombotic Risk Profile II 005203 dPT Confirm Ratio Ratio 75884-7
117205 Thrombotic Risk Profile II 161812 Anticardiolipin Ab,IgG,Qn GPL U/mL 3181-5
117205 Thrombotic Risk Profile II 161830 Anticardiolipin Ab,IgM,Qn MPL U/mL 3182-3
117205 Thrombotic Risk Profile II 161838 Anticardiolipin Ab,IgA,Qn APL U/mL 5076-5
117205 Thrombotic Risk Profile II 163881 Beta-2 Glycoprotein I Ab, IgG GPI IgG units 16135-6
117205 Thrombotic Risk Profile II 163899 Beta-2 Glycoprotein I Ab, IgA GPI IgA units 21108-6
117205 Thrombotic Risk Profile II 163907 Beta-2 Glycoprotein I Ab, IgM GPI IgM units 16136-4
117205 Thrombotic Risk Profile II 117910 Antiphosphatidylserine IgM Units 14246-3
117205 Thrombotic Risk Profile II 117926 Antiphosphatidylserine IgA APS Units 13069-0
117205 Thrombotic Risk Profile II 117927 Antiphosphatidylserine IgG Units 14245-5
Reflex Table for Act.Prt.C Resist.
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 511260 Factor V Leiden Mutation 511262 Factor V Leiden 21667-1
Reflex Table for Act.Prt.C Resist.
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 511260 Factor V Leiden Mutation 512256 Reviewed by: Pending
Reflex Table for PTT-LA
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 117040 PTT-LA Mix 117005 PTT-LA Mix sec 75510-8
Reflex 2 117020 Hexagonal Phase Phospholipid 117842 Hexagonal Phase Phospholipid sec 3282-1
Reflex Table for PTT-LA
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 117040 PTT-LA Mix 117005 PTT-LA Mix sec 75510-8
Reflex 2 117035 PTT-LA Incub Mix 117036 PTT-LA Incub Mix sec 50760-8
Reflex 3 117020 Hexagonal Phase Phospholipid 117842 Hexagonal Phase Phospholipid sec 3282-1

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