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Lupus Anticoagulant Comprehensive

Test Number 117054
Test number copied
CPT 85613; 85670; 85705; 85732

Test Details

Methodology

Clot-based clotting time assays

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 Information

Related Documents

For more information, please view the literature below.

Procedures for Hemostasis and Thrombosis: A Clinical Test Compendium

Test Includes

LA-sensitive activated partial thromboplastin time (PTT-LA); dilute Russell viper venom time (dRVVT); dilute prothrombin time (dPT); dPT confirm ratio; thrombin time. If PTT-LA, dRVVT or thrombin time are extended, reflex testing is performed and additional charges/CPT code(s) will apply.

Use

Qualitative detection of lupus anticoagulants in plasma6

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 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; 2008. NCCLS 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
6. Brandt JT, Triplett DA, Alving B, et al. Criteria for the diagnosis of lupus anticoagulants: An update. On behalf of the Subcommittee on Lupus Anticoagulant/Antiphospholipid Antibody of the Scientific and Standardization Committee of the ISTH. Thromb Haemost. 1995 Dec; 74(4):1185-1190. 8560433
7. Brandt JT, Barna LK, Triplett DA. Laboratory identification of lupus anticoagulants: Results of the Second International Workshop for Identification of Lupus Anticoagulants. On behalf of the Subcommittee on Lupus Anticoagulant/Antiphospholipid Antibodies of the ISTH. Thromb Haemost. 1995 Dec; 74(6):1597-1603. 8772243
8. 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.
9. Levine JS, Branch DW, Rauch J. The aAntiphospholipid syndrome. N Engl J Med. 2002 Mar 7; 346(10):752-763. 11882732
10. Greaves M, Cohen H, MacHin SJ, Mackie I. Guidelines on the investigation and management of the antiphospholipid syndrome. Br J Haematol. 2000 Jun; 109(4):704-715. 10929019
11. Arnout J, Vanrusselt M, Huybrechts E, Vermylen J. Optimization of the dilute prothrombin time for the detection of the lupus anticoagulant by use of a recombinant tissue thromboplastin. Br J Haematol. 1994 May; 87(1):94-99. 7947261

Custom Additional Information

Lupus anticoagulants are antibodies that inhibit one or more of the in vitro phospholipid-dependent tests of coagulation.6-10 Recently, the SCC Subcommittee for the Standardization of Lupus Anticoagulants provided guidelines for the laboratory diagnosis of LA.6 No single screening test can detect all LA-positive patients. The ISTH recommends that any sample suspected of having LA be tested using two or more LA screening tests.6,7 The screening tests commonly used to detect LA assess inhibitors of the intrinsic pathway (aPTT) and the common pathways (dRVVT). The dPT assay screens for phospholipid-dependent inhibitors of a different part of the coagulation cascade, the extrinsic pathway.11 The thrombin time is included to rule out heparin and other thrombin inhibitors.

Specimen Requirements

Specimen

Plasma, frozen

Volume

3 mL

Minimum Volume

2 mL (Note: This volume does not allow for repeat testing.)

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.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.

Storage Instructions

Freeze.

Patient Preparation

Ideally, the patient should not be on anticoagulant therapy. Avoid warfarin (Coumadin®) therapy for two weeks prior to the test and heparin, direct Xa, and thrombin inhibitor therapies for about three days prior to testing.

Causes for Rejection

Severe hemolysis; improper labeling; clotted specimen; specimen diluted with IV fluids; samples thawed in transit; improper sample type; sample out of stability

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
117054 Lupus Anticoagulant Comp 103620-1 005201 Dilute Prothrombin Time(dPT) sec 75508-2
117054 Lupus Anticoagulant Comp 103620-1 005203 dPT Confirm Ratio Ratio 75884-7
117054 Lupus Anticoagulant Comp 103620-1 109009 Thrombin Time sec 3243-3
117054 Lupus Anticoagulant Comp 103620-1 117003 PTT-LA sec 34571-0
117054 Lupus Anticoagulant Comp 103620-1 117891 dRVVT sec 6303-2
117054 Lupus Anticoagulant Comp 103620-1 117893 Lupus Reflex Interpretation 75514-0
Order Code117054
Order Code NameLupus Anticoagulant Comp
Order Loinc103620-1
Result Code005201
Result Code NameDilute Prothrombin Time(dPT)
UofMsec
Result LOINC75508-2
Order Code117054
Order Code NameLupus Anticoagulant Comp
Order Loinc103620-1
Result Code005203
Result Code NamedPT Confirm Ratio
UofMRatio
Result LOINC75884-7
Order Code117054
Order Code NameLupus Anticoagulant Comp
Order Loinc103620-1
Result Code109009
Result Code NameThrombin Time
UofMsec
Result LOINC3243-3
Order Code117054
Order Code NameLupus Anticoagulant Comp
Order Loinc103620-1
Result Code117003
Result Code NamePTT-LA
UofMsec
Result LOINC34571-0
Order Code117054
Order Code NameLupus Anticoagulant Comp
Order Loinc103620-1
Result Code117891
Result Code NamedRVVT
UofMsec
Result LOINC6303-2
Order Code117054
Order Code NameLupus Anticoagulant Comp
Order Loinc103620-1
Result Code117893
Result Code NameLupus Reflex Interpretation
UofM
Result LOINC75514-0
Reflex Table for Thrombin Time
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 117110 TT Mix+TTN 117171 Thrombin Time Mix sec 33525-7
Reflex 1
Order Code117110
Order NameTT Mix+TTN
Result Code117171
Result NameThrombin Time Mix
UofMsec
Result LOINC33525-7
Reflex Table for Thrombin Time
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 117110 TT Mix+TTN 117203 Thrombin Neutralization sec 46224-2
Reflex 1
Order Code117110
Order NameTT Mix+TTN
Result Code117203
Result NameThrombin Neutralization
UofMsec
Result LOINC46224-2
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 1
Order Code117040
Order NamePTT-LA Mix
Result Code117005
Result NamePTT-LA Mix
UofMsec
Result LOINC75510-8
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 1
Order Code117040
Order NamePTT-LA Mix
Result Code117005
Result NamePTT-LA Mix
UofMsec
Result LOINC75510-8