Lupus Anticoagulant Panel


Abbrev Code:LUPUSB   
Order Code:LAB3596Order 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 Codes: 85730 x1, 85730 x1, 85732 x1, 85732 x1, 85597 x1, 85597 x1, 85613 x1, 85613 x1, 85613 x1, 85613 x1, 85525 x1, 85525 x1, 85613 x1, 85613 x1, 85390 x1, 85390 x1
Test Includes:See Special Instructions.
Turnaround Time:Turnaround time is 2 days, testing performed 5 day per week (Monday-Friday). With pre-notification, STATs are done within 1 hour after receipt in the testing laboratory.
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 1.20 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.
Container:Blue Na Citrate, 3.2% - fill to fill line on tube
Collection Instructions:See link to Specimen Collection and Processing for Coagulation Specimens.
Causes for Rejection:Underfilled tubes, overfilled tubes, clotted specimens, not received or processed and frozen within 4 hours of collection or, specimen thawed during transit. Interfering medications (e.g., apixaban, argatroban, bivalirudin, dabigatran, fondaparinux, rivaoxaban, edoxaban). Recommend testing when patient is not on anticoagulants.


Processing and Shipping

Specimen Processing:
  • Process for Platelet Poor Plasma within 4 hours of collection.
  • Aliquot plasma, place clear tape around label, and freeze at -20C or on dry ice within 4 hours of collection.
  • If multiple tests are collected on 1 blue top, split each blue top into 2 aliquots. Minimum 0.5 mL per tube.
  • A maximum of 6 aliquots are needed per collection.
     
See link to Specimen Collection and Processing for Coagulation Specimens.
Shipping Instructions:
  • Ensure specimen is frozen before shipping.
  • Ship on dry ice, sample must remain frozen during shipping.
     
See link to Specimen Collection and Processing for Coagulation Specimens.
Test Performed at or Referral Lab UM Special Coag (K)  (UMMC East Bank)


Interpretive

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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