Test Details
Methodology
See individual tests.
Result Turnaround Time
3 - 7 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.
Test Includes
This test includes Activated Protein C Resistance (APCR); Antithrombin (AT) Activity; Factor VIII Activity; Homocyst(e)ine; Plasminogen Activator Inhibitor 1 (PAI-1) Activity Protein C, Functional; and Protein S, Free.
Use
This profile is designed to detect causes of congenital thrombophilia (inherited blood clotting disorders present from birth, increasing the risk of developing blood clots). These conditions arise from genetic abnormalities in proteins involved in blood coagulation, making the blood more prone to forming clots than normal.
Refer to individual test descriptions for more information.
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.
Specimen Requirements
Specimen
Sodium citrate plasma, frozen, and for homocysteine, plasma (preferred); serum is acceptable
Volume
3 mL frozen plasma and 1.2 mL plasma or serum
Container
Blue-top (sodium citrate) tube and lavender-top (EDTA) tube, green-top (heparin) tube, red-top tube or gel-barrier 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 anti-coagulant 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 non-citrate 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 recentifuge for 10 minutes. Use a second plastic pipette to remove 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. To avoid delays in turnaround time when requesting multiple tests on frozen samples, please submit separate frozen specimens for each test requested. It is important to centrifuge blood samples for plasma collection immediately after collection to separate the plasma from the blood cells. If immediate centrifugation is not possible, collected blood specimens should be kept on ice and centrifuged within an hour.
Other plasma: It is important to centrifuge blood samples for plasma collection immediately after collection to separate the plasma from the blood cells. If immediate centrifugation is not possible, collected blood specimens should be kept on ice and centrifuged within an hour.
Serum: Sample should be centrifuged as soon as possible after collection to avoid false elevation of homocysteine and transported in a completely separated gel barrier-tube (SST) or transfer tube.
Please print and use the Volume Guide for Coagulation Testing to ensure proper draw volume.
Stability Requirements
See individual tests.
Storage Instructions
Freeze citrate plasma. Store EDTA plasma or serum at room temperature.
Patient Preparation
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
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. PubMed 8980376
2. Reneke J, Etzell J, Leslie S, Ng VL, Gottfried EL. Prolonged pro-thrombin 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. PubMed 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. PubMed 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. PubMed 10539100
LOINC® Map
| Order Code | Order Code Name | Order Loinc | Result Code | Result Code Name | UofM | Result LOINC |
|---|---|---|---|---|---|---|
| 117185 | Thrombotic Risk, Congenital Ex | 117763 | Act.Prt.C Resist. | ratio | 13590-5 | |
| 117185 | Thrombotic Risk, Congenital Ex | 015040 | Antithrombin Activity | % | 27811-9 | |
| 117185 | Thrombotic Risk, Congenital Ex | 117705 | Protein C-Functional | % | 27818-4 | |
| 117185 | Thrombotic Risk, Congenital Ex | 164519 | Protein S, Free | % | 27821-8 | |
| 117185 | Thrombotic Risk, Congenital Ex | 086264 | Factor VIII Activity | % | 3209-4 | |
| 117185 | Thrombotic Risk, Congenital Ex | 146788 | Plasminogen Act Inhibitor-1 | IU/mL | 5975-8 | |
| 117185 | Thrombotic Risk, Congenital Ex | 707009 | Homocyst(e)ine | umol/L | 13965-9 | |
| Order Code | 117185 | |||||
| Order Code Name | Thrombotic Risk, Congenital Ex | |||||
| Order Loinc | ||||||
| Result Code | 117763 | |||||
| Result Code Name | Act.Prt.C Resist. | |||||
| UofM | ratio | |||||
| Result LOINC | 13590-5 | |||||
| Order Code | 117185 | |||||
| Order Code Name | Thrombotic Risk, Congenital Ex | |||||
| Order Loinc | ||||||
| Result Code | 015040 | |||||
| Result Code Name | Antithrombin Activity | |||||
| UofM | % | |||||
| Result LOINC | 27811-9 | |||||
| Order Code | 117185 | |||||
| Order Code Name | Thrombotic Risk, Congenital Ex | |||||
| Order Loinc | ||||||
| Result Code | 117705 | |||||
| Result Code Name | Protein C-Functional | |||||
| UofM | % | |||||
| Result LOINC | 27818-4 | |||||
| Order Code | 117185 | |||||
| Order Code Name | Thrombotic Risk, Congenital Ex | |||||
| Order Loinc | ||||||
| Result Code | 164519 | |||||
| Result Code Name | Protein S, Free | |||||
| UofM | % | |||||
| Result LOINC | 27821-8 | |||||
| Order Code | 117185 | |||||
| Order Code Name | Thrombotic Risk, Congenital Ex | |||||
| Order Loinc | ||||||
| Result Code | 086264 | |||||
| Result Code Name | Factor VIII Activity | |||||
| UofM | % | |||||
| Result LOINC | 3209-4 | |||||
| Order Code | 117185 | |||||
| Order Code Name | Thrombotic Risk, Congenital Ex | |||||
| Order Loinc | ||||||
| Result Code | 146788 | |||||
| Result Code Name | Plasminogen Act Inhibitor-1 | |||||
| UofM | IU/mL | |||||
| Result LOINC | 5975-8 | |||||
| Order Code | 117185 | |||||
| Order Code Name | Thrombotic Risk, Congenital Ex | |||||
| Order Loinc | ||||||
| Result Code | 707009 | |||||
| Result Code Name | Homocyst(e)ine | |||||
| UofM | umol/L | |||||
| Result LOINC | 13965-9 |