TEST CATALOG ORDERING & RESULTS SPECIMEN HANDLING CUSTOMER SERVICE EDUCATION & INSIGHTS
Test Catalog

Test ID: ALUPP    
Lupus Anticoagulant Profile, Plasma

Useful For Suggests clinical disorders or settings where the test may be helpful

Confirming or excluding the presence of lupus anticoagulant (LAC), distinguishing LAC from specific coagulation factor inhibitors and nonspecific inhibitors

 

Investigating a prolonged activated thromboplastin time, especially when combined with other coagulation studies

 

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.

Testing Algorithm Delineates situations 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 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 >13.9 seconds, PT mix will be performed at an additional charge.

 

If APTT is > or =38 seconds, APTT mix will be performed at an additional charge.

 

If PT, APTT, or DRVVT are prolonged, thrombin time (TT) will be performed at an additional charge.

 

If APTT mix is > or =38 seconds and thrombin time is <35.0 seconds (no evidence of heparin), platelet neutralization procedure will be performed at an additional charge.

 

If DRVVT ratio is > or =1.20, DRVVT mix and DRVVT confirmation will be performed at an additional charge.

 

If TT is > or =25.0 seconds, reptilase will be performed at an additional charge.

 

If appropriate, coagulation factor assays, fibrinogen, D-dimer, Staclot LA, and soluble fibrin monomer will be performed to clarify a significant abnormality in the screen test results at an additional charge.

 

If the factor VIII, IX or V result is below the normal range, the factor inhibitor screen may be performed along with the Bethesda titering assay, if indicated, at an additional charge.

 

If any test results are abnormal, all results will be reviewed by a coagulation consultant and a Lupus Anticoagulant Interpretation will be provided.

 

See Lupus Anticoagulant Profile Testing Algorithm in Special Instructions.

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.

An interpretive report will be provided.

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

No significant cautionary statements

Clinical Reference Recommendations for 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

Special Instructions Library of PDFs including pertinent information and forms related to the test