Thrombotic Risk Profile I

CPT: 81240; 83090; 85300; 85303; 85306; 85307; 85420; 85613; 85705; 85732; 86146(x2); 86147(x2)
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Test Details

Test Includes

Activated protein C resistance (APCR) with reflex to factor V Leiden mutation analysis; anticardiolipin antibodies (ACA), quantitative, IgG, IgM; antithrombin activity; β2-glycoprotein 1 antibodies, IgG, IgM; dilute prothrombin time; factor II (prothrombin), DNA analysis; homocyst(e)ine, plasma; lupus anticoagulant with reflex; plasminogen activity; protein C, functional; protein S, free

Methodology

See individual tests.

Specimen Requirements

Specimen

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

Volume

6 mL frozen plasma (3 mL plasma into each of two tubes) and 2 mL serum and 7 mL whole blood or buccal swab

Minimum Volume

3 mL frozen plasma and 2 mL serum and 3 mL whole blood or buccal swabs

Container

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

Patient Preparation

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

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 (ie, "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 N° 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.

Clinical Information

Special Instructions

Note: If the Activated Protein C Resistance (APCR) [117762] result is <2.0, it will reflex to Factor V Leiden Mutation Analysis [511154] at an additional charge.

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. 1997Jan; 107(1):105-110. 8980376
2. Reneke J, Etzell J, Leslie S, Ng VL, Gottfried EL. 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 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 AI, Levine MN, Konkle BA, Kearon C. Thrombotic disorders: Diagnosis and treatment. Hematology (Am Soc Hematol Educ Program). 2003:520-539. 14633797
Triplett DA. Thrombophilia. In: McClatchey 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
117702 Thrombotic Risk Profile I 707009 Homocyst(e)ine umol/L 13965-9
117702 Thrombotic Risk Profile I 117714 Plasminogen % 5970-9
117702 Thrombotic Risk Profile I 015040 Antithrombin Activity % 27811-9
117702 Thrombotic Risk Profile I 117705 Protein C-Functional % 27819-2
117702 Thrombotic Risk Profile I 164519 Protein S, Free % 27821-8
117702 Thrombotic Risk Profile I 117763 Act.Prt.C Resist. ratio 13590-5
117702 Thrombotic Risk Profile I 117871 FVDNA TRACKING N/A
117702 Thrombotic Risk Profile I 117003 PTT-LA sec 34571-0
117702 Thrombotic Risk Profile I 117891 dRVVT sec 6303-2
117702 Thrombotic Risk Profile I 117893 Lupus Reflex Interpretation 75514-0
117702 Thrombotic Risk Profile I 005201 Dilute Prothrombin Time(dPT) sec 75508-2
117702 Thrombotic Risk Profile I 005203 dPT Confirm Ratio Ratio 75884-7
117702 Thrombotic Risk Profile I 161812 Anticardiolipin Ab,IgG,Qn GPL U/mL 3181-5
117702 Thrombotic Risk Profile I 161830 Anticardiolipin Ab,IgM,Qn MPL U/mL 3182-3
117702 Thrombotic Risk Profile I 163881 Beta-2 Glycoprotein I Ab, IgG GPI IgG units 16135-6
117702 Thrombotic Risk Profile I 163907 Beta-2 Glycoprotein I Ab, IgM GPI IgM units 16136-4
117702 Thrombotic Risk Profile I 511218 Factor II, DNA Analysis 24476-4
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 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 000000 117842 000000 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 000000 117036 000000 sec 50760-8 117020
Reflex 3 000000 117842 000000 sec 3282-1

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