Lupus Anticoagulant Panel


Sunquest Code:LUPUSB  
Epic Code:LAB3596Epic Name:Lupus Anticoagulant Panel
Synonyms:Lupus Anticoagulant; Anti-Phospholipids Antibody; Antiphospholipid; Inhibitor; Anti Phospholipids; Circulation Anticoagulant; Lupus Anticoagulant; Russell Viper Venom; LUPUSB
Methodology:aPTT's, aPTT's plus lysed platelet phospholipid, DRVVT snake venom, DRVVT snake venom with added phospholipid, hepzyme neutralization of heparin.
CPT Code:----------CPTCODES HERE----------
Test Includes:See Special Instructions.
Turnaround Time:Specimen is accepted and processed 24 hours/day, 7 days/week. Test is performed Mon-Fri; results are reported within 2 business days.
Special Instructions:
The following will always be performed: PTT and DRVVT Screen. If not ordered by the provider, a no charge Thrombin Time and INR will be performed. If the Thrombin Time is greater than 19.0 seconds and the PTT-LA ratio is greater than 1.16 and the PTT-LA is less than 180 seconds, the sample will be hepzymed (for an additional charge). See Lupus Anticoagulant Testing Algorithm in Associated Links.  
Associated Links:

Specimen Collection and Processing for Coagulation Specimens, Lupus Anticoagulant Testing Algorithm



Collection Instructions

Specimen:Blood
Optimal Volume:Three to four 3 mL tubes, each containing 2.7 mL blood; each filled to fill line on the tube.
Minimum\Peds Volume:One 3 mL tube containing 2.7 mL blood filled to fill line on the tube.
Collection Instructions:See link to Specimen Collection and Processing for Coagulation Specimens.
Causes for Rejection:Underfilled tube or clotted specimens. Interferring medications (e.g., apixaban, argatroban, bivalirudin, dabigatran, fondaparinux, rivaoxaban, edoxaban). Recommend testing when patient is not on anticoagulants.


Processing and Shipping

Specimen Processing:See link to Specimen Collection and Processing for Coagulation Specimens.
Shipping Instructions:See link to Specimen Collection and Processing for Coagulation Specimens.
Test Performed at or Referral Lab Special Coagulation  (UMMC-East Bank)


Interpretive

Critical Range:
Reference Range:Interpretive by report.
Use:To detect lupus anticoagulant antiphospholipid antibodies. These are IgG, IgM or IgA antibodies directed against proteins that bind to phospholipid. They are associated with arterial and venous thromboembolism, thrombocytopenia and recurrent pregnancy loss. Some lupus anticoagulants are transient, possibly due to viral infections, drug reactions, etc. Bleeding is rarely seen in conjunction with a lupus anticoagulant and in this situation is usually associated with a low Factor 2 level. If patient had bleeding symptoms factor levels are recommended even if the lupus anticoagulant test is positive. False positive results may be seen in patients with clinical conditions associated with an elevated C-Reactive Protein (CRP) and in patients on anticoagulants. The laboratory uses two methods (PTT and DRVVT) to detect lupus anticoagulant because of the heterogeneity of antibody reactivity.


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