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TEST ID AATHR Thrombophilia Profile, Plasma and Whole Blood

Reporting Name

Thrombophilia Prof

Specimen Type

Plasma Na Cit
Whole blood


Ordering Guidance


Multiple coagulation profile tests are available. See Coagulation Profile Comparison for testing that is performed with each profile.



Shipping Instructions


Send all specimens in the same shipping container.



Specimen Required


Both blood and plasma are required.

 

Patient Preparation:

1. Patient should not be receiving Coumadin (warfarin), heparin, direct thrombin inhibitors (argatroban, dabigatran), or direct factor Xa inhibitors (apixaban, rivaroxaban, and edoxaban).

2. Specimen must be collected prior to initiation of anticoagulants and thrombolytic therapy.

3. If patient has been recently transfused, it is best to perform this study pretransfusion, if possible.

 

Specimen Type: Whole blood

Container/Tube:

Preferred: Lavender top (EDTA)

Acceptable: Yellow top (ACD), light-blue top (3.2% sodium citrate)

Specimen Volume: 3 mL

Collection Instructions:

1. Invert several times to mix blood.

2. Send whole blood specimen in original tube. Do not aliquot.

3. Label specimen as whole blood.

 

Specimen Type: Platelet-poor plasma

Collection Container/Tube: Light-blue top (3.2% sodium citrate)

Submission Container/Tube: Plastic vial (polypropylene preferred)

Specimen Volume: 5 mL in 5 plastic vials; each containing 1 mL

Collection Instructions:

1. Specimen must be collected prior to factor replacement therapy.

2. For complete instructions, see Coagulation Guidelines for Specimen Handling and Processing.

3. Centrifuge, transfer all plasma into a plastic vial, and centrifuge plasma again.

4. Aliquot plasma (1-2 mL per aliquot) into 5 separate plastic vials leaving 0.25 mL in the bottom of centrifuged vial.

5. Freeze plasma immediately (no longer than 4 hours after collection) at -20° C or, ideally, -40° C or below.

Additional Information: Double-centrifuged specimen is critical for accurate results as platelet contamination may cause spurious results.


Specimen Minimum Volume

Plasma: 5 mL total, 5 plastic vials each containing 1 mL, Whole blood: 1 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Plasma Na Cit Frozen 14 days
Whole blood Ambient (preferred) 14 days
  Frozen  14 days
  Refrigerated  14 days

Testing Algorithm

Initial testing includes prothrombin time (PT); activated partial thromboplastin time (aPTT); dilute Russell's viper venom time (dRVVT); thrombin time (bovine); fibrinogen; D-dimer; antithrombin activity; protein C activity; protein S antigen, free; prothrombin G20210A variant; activated protein resistance V; and thrombophilia interpretation.

 

If the PT is greater than 13.9 seconds, then the PT mixing study will be performed at an additional charge.

 

If the aPTT is 38 seconds or more, then the aPTT mixing study will be performed at an additional charge.

 

If the aPTT mix result is 38 seconds or more and thrombin time is less than 35.0 seconds (no evidence of heparin), then the platelet neutralization procedure will be performed at an additional charge.

 

If the dRVVT ratio is 1.20 or more, then the dRVVT mixing study and dRVVT confirmation will be performed at an additional charge.

 

If the thrombin time is 25.0 or more seconds, then the reptilase time will be performed at an additional charge.

 

If the fibrinogen result is less than 150 mg/dL or clinically indicated, then PT-fibrinogen will be performed at an additional charge.

 

If the D-dimer result is greater than 500 ng/mL fibrinogen equivalent units (FEU), then soluble fibrin monomer testing will be performed at an additional charge.

 

If the free protein S antigen result is less than 65% for men and women 50 years of age or older and less than 50% for women and girls younger than 50 years of age, then the total protein S antigen test will be performed at an additional charge.

 

If the protein C activity is less than 70% with no evidence for an acquired decrease in protein C activity, then protein C antigen testing may be performed at an additional charge.

 

If the antithrombin activity is less than 80% with no evidence of an acquired decrease in antithrombin activity, then antithrombin antigen testing will be performed at an additional charge.

 

If the activated protein C resistance (APC) ratio is less than 2.3 or the baseline APC aPTT is prolonged, then factor V Leiden (R506Q) variant analysis will be performed at an additional charge.

 

If appropriate, protein S activity, coagulation factor assays, or hexagonal lupus anticoagulant will be performed, at an additional charge, to clarify significant abnormalities in the screen test results.

 

For more information see Thrombophilia Profile

Method Name

PTSC, APTSC, DRV1, TTSC, APCRV: Optical Clot-Based

CLFIB: Clauss

DIMER, PSF: Latex Immunoassay (LIA)

ATTF, CFX: Chromogenic

PTNT: Direct Variant Analysis

AATHI: Medical Interpretation

Reject Due To

Gross hemolysis Reject
Gross lipemia Reject
Gross icterus Reject

Reference Values

An interpretive report will be provided.

Day(s) Performed

Weekly

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
ATTI Antithrombin Antigen, P Yes No
FACTV Coag Factor V Assay, P Yes No
F_7 Coag Factor VII Assay, 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
RTSC Reptilase Time, P Yes No
F_2 Coag Factor II Assay, P Yes No
PCAG Protein C Ag, P Yes No
F5DNA Factor V Leiden (R506Q) Mutation, B Yes No
PNP Platelet Neutralization Procedure No No
PTMSC PT Mix 1:1 No No
APMSC APTT Mix 1:1 No No
PST Protein S Ag, Total, P No No
DRV2 DRVVT Mix No No
DRV3 DRVVT Confirmation No No
SOLFM Soluble Fibrin Monomer No No
PTFIB PT-Fibrinogen, P No No
HEXLA HEX LA, P No No
SFX Protein S Activity, P Yes No

Report Available

4 to 7 days

Specimen Retention Time

Plasma: 7 days; Whole blood: 2 weeks

Performing Laboratory

Mayo Clinic Laboratories in Rochester

CPT Code Information

81240-F2 PTNT

85300-ATTF

85303-CFX

85306-PSF

85307-APCRV

85379-DIMER

85384-CLFIB

85390-26-AATHI

85610-PTSC

85613-DRV1

85670-TTSC

85730-APTSC

81241-F5 (coagulation factor V) (eg, hereditary hypercoagulability) gene analysis, Leiden variant (if appropriate)

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)

85301-Antithrombin antigen (if appropriate)

85302-Protein C antigen (if appropriate)

85305-Protein S antigen, total (if appropriate)

85306-Protein S activity (if appropriate)

85366-Soluble fibrin monomer (if appropriate)

85385-PT-Fibrinogen (if appropriate)

85597-Platelet neutralization for lupus inhibitor (if appropriate)

85598-Hex LA (if appropriate)

85611-PT mix 1:1 (if appropriate)

85613-DRVVT mix (if appropriate)

85613-DRVVT confirmation (if appropriate)

85635-Reptilase (if appropriate)

85732 - APTT Mix 1:1 (if appropriate)

Useful For

Evaluating patients with thrombosis or hypercoagulability states

 

Detecting a lupus-like anticoagulant; dysfibrinogenemia; disseminated intravascular coagulation/intravascular coagulation and fibrinolysis

 

Detecting a deficiency of antithrombin, protein C, or protein S

 

Detecting activated protein C resistance (and the factor V Leiden [p.Arg534Gln, historically known as R506Q] variant if indicated)

 

Detecting the prothrombin F2 c.*97G>A variant (historically known as G20210A)

Profile Information

Test ID Reporting Name Available Separately Always Performed
AATHI Thrombophilia Interpretation No Yes
PTSC Prothrombin Time (PT), P Yes, (order PTTP) Yes
APTSC Activated Partial Thrombopl Time, P Yes, (order APTTP) Yes
DRV1 Dilute Russells Viper Venom Time, P Yes, (order DRVI1) Yes
TTSC Thrombin Time (Bovine), P Yes Yes
CLFIB Fibrinogen, Clauss, P Yes, (order FIBTP) Yes
DIMER D-Dimer, P Yes, (order DDITT) Yes
ATTF Antithrombin Activity, P Yes Yes
CFX Protein C Activity, P Yes Yes
PSF Protein S Ag, Free, P Yes, (order PSTF) Yes
APCRV Activated Protein Resistance V, P Yes Yes
PTNT Prothrombin G20210A Mutation, B Yes Yes