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.

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
ALUPI Lupus Anticoagulant Tech Interp No Yes
PTSC Prothrombin Time (PT), P Yes, Bill Only Yes
APTSC Activated Partial Thrombopl Time, P Yes, Bill Only Yes
DRV1 Dilute Russells Viper Venom Time, P Yes, Bill Only Yes

Reflex Tests
Lists tests that may or may not be performed, at an additional charge, depending on the result and interpretation of the initial tests.

Test Id Reporting Name Available Separately Always Performed
DIMER D-Dimer, P Yes, Bill Only 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
TTSC 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
RTSC Reptilase Time, P Yes No
F_2 Coag Factor II Assay, P Yes No
CLFIB Fibrinogen, Clauss, P Yes, Bill Only No
SOLFM Soluble Fibrin Monomer No No
PNP Platelet Neutralization Procedure No No
PTMSC PT Mix 1:1 No No
APMSC APTT Mix 1:1 No No
DRV2 DRVVT Mix No No
DRV3 DRVVT Confirmation No No
ALUPO Lupus Anticoagulant Interp No No
STACL Staclot LA, P No No
RIST Ristocetin Cofactor, P No No
F5_IS Factor V Inhib Scrn No No
VWFMP von Willebrand Factor Multimer, P Yes, Bill Only No
PTFIB PT-Fibrinogen, P Yes No
VWAG von Willebrand Factor Ag, P Yes No
VWACT von Willebrand Factor Activity, P Yes No
CH9 Chromogenic FIX, P Yes No
5BETH FV Bethesda Units, P No No
F9_IS Factor IX Inhib Scrn No No
8BETH FVIII Bethesda Units, P No No
9BETH FIX Bethesda Units, P No No
CHF8 Chromogenic FVIII, P Yes No

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.

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

Method Name
A short description of the method used to perform the test

PTSC, APTSC, DRV1: Optical Clot-Based

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Lupus Anticoagulant Prof

Aliases
Lists additional common names for a test, as an aid in searching

APTT Mixing Studies

Coag

Dilute Russell Viper Venom Time (DRVVT)

DRVVT (Dilute Russell Viper Venom Time)

Phospholipid Antibodies

Platelet Neutralization Procedure (PNP Coag Consult)

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.

Specimen Type
Describes the specimen type validated for testing

Plasma Na Cit

Ordering Guidance

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

Shipping Instructions

Send the aliquots in the same shipping container.

Necessary Information

1. If priority specimen, mark request form, give reason, and request a call-back.

2. Note if patient is currently receiving anticoagulant (eg, heparin, Coumadin [warfarin]) treatment.

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Patient Preparation:

1. Patient should not be receiving anticoagulant treatment (eg, warfarin, heparin). Treatment with heparin causes false-positive results of in vitro coagulation testing for lupus anticoagulant. Coumadin (warfarin) treatment may impair ability to detect the more subtle varieties of lupus-like anticoagulants.

2. Patient should also not be receiving fibrinolytic agents (streptokinase, urokinase, tissue plasminogen activator: tPA).

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

 

Specimen Type: Platelet-poor plasma

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

Submission Container/Tube: Plastic vials

Specimen Volume: 4 mL in 4 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 in Special Instructions.

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

4. Aliquot plasma (1-2 mL per aliquot) into 4 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 degrees C or, ideally, < or =-40 degrees C.

Additional Information:

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

2. Each coagulation assay requested should have its own vial.

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

Forms

1. Coagulation Patient Information (T675) in Special Instructions.

2. If not ordering electronically, complete, print, and send a Coagulation Test Request (T753) with the specimen.

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the Testing Laboratory

See Specimen Required

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

Gross hemolysis Reject
Gross lipemia Reject
Gross icterus Reject

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Plasma Na Cit Frozen (preferred) 14 days

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

Method Description
Describes how the test is performed and provides a method-specific reference

Prothrombin Time: Optical clot-based

The prothrombin time (PT) assay is performed on the Instrumentation Laboratory ACL TOP. Patient plasma is incubated and combined with a PT reagent containing recombinant human tissue factor, synthetic phospholipids, calcium chloride, polybrene, and buffer. The tissue thromboplastin-factor VII/VIIa complex activates factor X. Activated factor X (factor Xa) forms a complex with factor Va, calcium, and phospholipid to activate factor II (prothrombin) to thrombin. Thrombin then acts on fibrinogen (factor I) to form fibrin which clots, the time to clot formation is measured optically using a wavelength of 671 nm providing the assay endpoint (the "prothrombin time").(Package insert: HemosIL RecombiPlasTin 2G Instrumentation Laboratory Company, R0, 3/2019)

 

Activated Partial Thromboplastin Time: Optical clot-based

The activated partial thromboplastin time (APTT) assay is performed on the Instrumentation Laboratory ACL TOP. Patient plasma is combined and incubated with an APTT reagent containing phospholipid, a negatively charged contact factor activator, and buffer. After a specified incubation time, calcium is added to trigger the coagulation process in the mixture. Subsequently, the time to clot formation is measured optically using a wavelength of 671 nm. Mixing studies (see APMSC / Activated Partial Thromboplastin Time (APTT) Mix 1:1, Plasma) using normal pooled plasma are performed in the Special Coagulation Laboratory on samples with a prolonged APTT, to assist in discriminating between factor deficiency states and coagulation inhibitors, unless further testing is not indicated.(Package insert: HemosIL SynthASil. Instrumentation Laboratory Company, R11, 06/2017)

 

Dilute Russell’s Viper Venom Time: Optical clot-based

The dilute Russell viper venom time (DRVVT) screening assay is performed on the Instrumentation Laboratory ACL TOP. Patient plasma is incubated for a specified time, and then combined with a DRVVT screening reagent containing Russell viper venom, phospholipids, heparin neutralizing agents, calcium, buffers and stabilizers to trigger the coagulation process. Subsequently, the time to clot formation is measured optically using a wavelength of 671 nm. The patient DRVVT screening clotting time is normalized by dividing the patient result by the mean DRVVT screening clotting time of normal pooled plasma to yield a ratio (DRVVT screen ratio).(Package insert: LA CHECK DRVVT Precision Biologic, R14, 03/2012)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday through Friday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

3 to 5 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

7 days

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their Regional Manager. For assistance, contact Customer Service.

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 instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

See Individual Test IDs

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 Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

85610

85730

85613

85390

85130 (if appropriate)

85130 (if appropriate)

85210 (if appropriate)

85220 (if appropriate)

85230 (if appropriate)

85240 (if appropriate)

85245 (if appropriate)

85246 (if appropriate)

85247 (if appropriate)

85250 (if appropriate)

85260 (if appropriate)

85270 (if appropriate)

85280 (if appropriate)

85335 (if appropriate)

85335 (if appropriate)

85335 (if appropriate)

85366 (if appropriate)

85379 (if appropriate)

85384 (if appropriate)

85385 (if appropriate)

85390-26 (if appropriate)

85397 (if appropriate)

85597 (if appropriate)

85598 (if appropriate)

85611 (if appropriate)

85613 (if appropriate)

85613 (if appropriate)

85635 (if appropriate)

85670 (if appropriate)

85732 (if appropriate)

LOINC® Information

Test Id Test Order Name Order LOINC Value
ALUPP Lupus Anticoagulant Prof 75881-3
Result Id Test Result Name Result LOINC Value
Result LOINC Value Tooltip

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports