Test ID: LUPPR
Lupus Anticoagulant Profile
Secondary ID 
A test code used for billing and in test definitions created prior to November 2011
NY State Approved Indicates the status of NY State approval and if the test is orderable for NY State clients.
Useful For Suggests clinical disorders or settings where the test may be helpful
Confirming or excluding presence of lupus anticoagulant (LAC) distinguishing LAC from specific coagulation factor inhibitors and nonspecific inhibitors
Investigation of a prolonged activated thromboplastin time, especially when combined with other coagulation studies
Profile Information A profile is a group of laboratory tests that are ordered and performed together under a single Mayo Test ID. Profile information lists the test performed, inclusive of the test fee, when a profile is ordered and includes reporting names and individual availability.
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| PTC | Prothrombin Time (PT), P | Yes, (order PT) | Yes |
| APTTB | Activated Partial Thrombopl Time, P | Yes, (order APT) | Yes |
| DRVT | Dilute Russells Viper Venom Time, P | No | Yes |
| CCC1 | Interpretation | No | Yes |
Reflex Tests Lists test(s) that may or may not be performed, at an additional charge, depending on the result and interpretation of the initial test(s)
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| DIRM | D-Dimer, P | Yes, (order #9290) | No |
| IBETH | Bethesda Units | No | No |
| F8IS | Coag Factor VIII Assay Inhib Scrn,P | No | No |
| FACTV | Coag Factor V Assay, P | Yes | No |
| F_7 | Coag Factor VII Assay, P | Yes | No |
| TT | Thrombin Time (Bovine), P | Yes | No |
| F_9 | Coag Factor IX Assay, P | Yes | No |
| F_10 | Coag Factor X Assay, P | Yes | No |
| F_11 | Coag Factor XI Assay, P | Yes | No |
| F_12 | Coag Factor XII Assay, P | Yes | No |
| F8A | Coag Factor VIII Activity Assay, P | Yes | No |
| RPTL | Reptilase Time, P | Yes | No |
| F_2 | Coag Factor II Assay, P | Yes | No |
| FIBC | Fibrinogen, P | Yes, (order #8484) | No |
| SFM | Soluble Fibrin Monomer | No | No |
| PNP | Platelet Neutralization Procedure | No | No |
| PTMX | PT Mix 1:1 | No | No |
| APTTM | APTT Mix 1:1 | No | No |
| DRVTM | DRVVT Mix | No | No |
| DRVTC | DRVVT Confirmation | No | No |
| CCC2 | Special Coagulation Interpretation | No | No |
| STLA | Staclot LA, P | No | No |
Testing Algorithm Delineates situation(s) when tests are added to the initial order. This includes reflex and additional tests.
Initial testing includes: prothrombin time (PT), activated partial thromboplastin time (APTT), and dilute Russell's viper venom time (DRVVT).
If the PT, APTT, and DRVVT are normal, a computer-generated interpretive comment indicating no evidence of a lupus anticoagulant will be provided.
If PT is > or =14 seconds, PT mix will be performed.
If APTT is >36 seconds, APTT mix will be performed.
If APTT mix is >36 seconds with no evidence of heparin in sample, platelet neutralization procedure (PNP) will be performed.
If DRVVT ratio is > or =1.2, DRVVT mix will be performed.
If DRVVT mix ratio is > or =1.2, DRVVT confirm will be performed.
If PT, APTT, or DRVVT are prolonged, thrombin time (TT) will be performed.
If TT is >23 seconds, reptilase will be performed.
If appropriate, coagulation factor assays, fibrinogen, D-dimer, Staclot LA, and soluble fibrin monomer will be performed to clarify a significant abnormality in the screening clotting times.
If factor VIII result is <55%, the factor VIII inhibitor screen may be performed along with the Bethesda titering assay, if indicated.
If any test results are abnormal, all results will be reviewed by a coagulation consultant and a Special Coagulation Consultant Interpretation will be provided.
See Lupus Anticoagulant Profile Testing Algorithm in Special Instructions.
Special Instructions and Forms Describes specimen collection and preparation information, test algorithms, and other information pertinent to test. Also includes pertinent information and consent forms to be used when requesting a particular test
Method Name A short description of the method used to perform the test
PTC/6599, PTMX/9053, APTTB/6548, DRVT/80340, TT/9059, RPTL/9078, DRVTM/32467, DRVTC/32468, APTTM/9118, STLA/82756: Clot-Based Assay
DIRM/6625: Automated Latex Immunoassay (LIA)
PNP/8866: Activated Partial Thromboplastin Time (APTT) Mixing Test
F_2/9121, FACTV/9054, F_7/9055, F_10/9066, IBETH/7288, F8IS/7289: Prothrombin Clot-Based Assay
F8A/9070, F_9/9065, F_11/9067, F_12/9069: Activated Partial Thromboplastin Clot-Based Assay
FIBC/80343: Clauss Methodology
SFM/6600: Immunoturbidimetric
Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name
Aliases Lists additional common names for a test, as an aid in searching
Coag
Dilute Russell Viper Venom Time (DRVVT)
DRVVT (Dilute Russell Viper Venom Time)
Phospholipid Antibodies
Platelet Neutralization Procedure (PNP Coag Consult)
Specimen Type Describes the specimen type needed for testing
Specimen Required Defines the optimal specimen. This field describes the type of specimen required to perform the test and the preferred volume to complete testing. The volume allows automated processing, fastest throughput and, when indicated, repeat or reflex testing.
See Coagulation Studies in Special Instructions.
Specimen Type: Platelet-poor plasma
Collection Container/Tube: Light-blue top (citrate)
Submission Container/Tube: Plastic vials
Specimen Volume: 5 mL in 5 plastic vials each containing 1 mL
Collection Instructions:
1. Spin down, remove plasma, and spin plasma again.
2. Freeze specimens immediately at < or =-40 degrees C, if possible.
3. Send specimens in the same shipping container.
Additional Information:
1. Double-centrifuged specimen is critical for accurate results as platelet contamination may cause spurious results.
2. If priority specimen, mark request form, give reason, and request a call-back.
3. Each coagulation assay requested should have its own vial.
4. If multiple coagulation profiles are ordered, each profile must be on a separate order.
5. Patient should not be receiving Coumadin or heparin.
Forms: Coagulation Patient Information Sheet (Supply T675)
Specimen Minimum Volume Defines the amount of specimen required to perform an assay once, including instrument and container dead space. Submitting the minimum specimen volume makes it impossible to repeat the test or perform confirmatory or perform reflex testing. In some situations, a minimum specimen volume may result in a QNS (quantity not sufficient) result, requiring a second specimen to be collected.
Reject Due To Identifies specimen types and conditions that may cause the specimen to be rejected
| Hemolysis | Mild OK; Gross reject |
| Lipemia | Mild OK; Gross reject |
| Icterus | Mild OK; Gross reject |
| Other | NA |
Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the laboratory. Alternate acceptable temperature(s) are also included.
| Specimen Type | Temperature | Time |
|---|---|---|
| Plasma Na Cit | Frozen | 14 days |
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Lupus anticoagulant (LAC) is an antibody to negatively charged phospholipid that interferes with phospholipid-dependent coagulation tests.
LAC is found in, but not limited to, patients with systemic lupus erythematosus; LAC is associated with other autoimmune disorders and collagen vascular disease, and occurs in response to medications or certain infections (eg, respiratory tract infections in children) and in individuals with no obvious underlying disease.
LAC has been associated with arterial and venous thrombosis and fetal loss. Individuals with thrombocytopenia or factor II deficiency associated with LAC may be at risk for bleeding.
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
PROTHROMBIN TIME (PT)
10.3-12.8 seconds
INR
0.9-1.2
The INR is used only for patients on stable oral anticoagulant therapy. It makes no significant contribution to the diagnosis or treatment of patients whose PT is prolonged for other reasons.
ACTIVATED PARTIAL THROMBOPLASTIN TIME (APTT)
Adults: 26-36 seconds
The normal full-term newborn APTT may be up to 35% longer than in adults and even longer (up to twice the adult upper limit) in healthy premature infants. Typically, the APTT is in the adult reference range by age 3 months in healthy full-term infants and by age 6 months in healthy premature infants (30-60 weeks gestation)*.
26-36 seconds (>3-6 months)
*See Pediatric Hemostasis References in Coagulation Studies in Special Instructions.
DILUTE RUSSELL'S VIPER VENOM TIME
<1.2
Interpretation Provides information to assist in interpretation of the test results
An interpretive report will be provided when testing is complete.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
This test is not useful for the detection of antiphospholipid antibodies that do not affect coagulation tests. We recommend separate testing for serum phospholipid (cardiolipin) antibodies.
Patient should not be receiving warfarin or heparin. If the patient is currently on warfarin or heparin, this should be noted, treatment with heparin causes false-positive results of in vitro coagulation testing for lupus anticoagulant. Coumadin treatment may impair ability to detect the more subtle varieties of lupus-like anticoagulants.
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
1. Arnout J, Vermylen J: Current status and implications of autoimmune antiphospholipid antibodies in relation to thrombotic disease. J of Thromb Haemost 2003 May;1(5):931-942
2. Levin JS, Branch DW, Rauch J: The antiphospholipid syndrome. New Engl J Med 2002 March 7;346(10):752-763
3. Proven A, Bartlett RP, Moder KG et al: Clinical importance of positive tests for lupus anticoagulant and anticardiolipin antibodies. Mayo Clin Proc 2004,79(4):467-475
Method Description Describes how the test is performed and provides a method-specific reference
See individual unit codes.
Day(s) and Time(s) Test Performed Outlines the days and times the test is performed. This field reflects the day and time the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time required before the test is performed. Some tests are listed as continuously performed, which means assays are performed several times during the day.
Monday through Friday
Maximum Laboratory Time Defines the maximum time from specimen receipt at Mayo Medical Laboratories until the release of the test result
Specimen Retention Time Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location The location of the laboratory that performs the test
Test Classification Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer's instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR), Investigation Use Only (IUO) product, or a Research Use Only (RUO) product.
CPT Code Information Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Medical Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
85610-PT
85613-DRVVT
85730-APTT
85210-Factor II (if appropriate)
85220-Factor V (if appropriate)
85230-Factor VII (if appropriate)
85240-Factor VIII (if appropriate)
85250-Factor IX (if appropriate)
85260-Factor X (if appropriate)
85270-Factor XI (if appropriate)
85280-Factor XII (if appropriate)
85335-Bethesda units (if appropriate)
85335-Factor VIII inhibitor screen (if appropriate)
85366-Soluble fibrin monomer (if appropriate)
85379-D-dimer (if appropriate)
85384-Fibrinogen (if appropriate)
85390-26-Special coagulation interpretation (if appropriate)
85597-Platelet neutralization for lupus inhibitor (if appropriate)
85598-Staclot LA (if appropriate)
85611-PT mix 1:1 (if appropriate)
85613-DRVVT mix (if appropriate)
85613-DRVVT confirmation (if appropriate)
85635-Reptilase time (if appropriate)
85670-Thrombin time (if appropriate)
85732-APTT mix 1:1 (if appropriate)
LOINC® Code Information Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the result codes returned for this test or profile.
| Result ID | Reporting Name | LOINC Code |
|---|---|---|
| APTTB | Activated Partial Thrombopl Time, P | 14979-9 |
| 7525 | Interpretation | 69049-5 |
| RVVR | DRVVT Screen Ratio | 15359-3 |
| PR_TI | Prothrombin Time (PT), P | 5902-2 |
| INR2 | INR | 6301-6 |
| 7769 | Reviewed by: | N/A |
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