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HelpTest Code APCRR Activated Protein C Resistance V, with Reflex to Factor V Leiden, Blood and Plasma
Reporting Name
APCRV, w/Reflex, PPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Useful For
Evaluating patients with incident or recurrent venous thromboembolism (VTE)
Evaluating individuals with a family history of VTE
Method Name
Optical Clot-Based
Necessary Information
Specimen Required
Blood and plasma are required.
Patient Preparation: Fasting preferred
Specimen Type: Whole blood
Container/Tube:
Preferred: Lavender top (EDTA)
Acceptable: Yellow top (ACD) or 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.
Specimen Type: Platelet-poor plasma
Collection Container/Tube: Light-blue top (3.2% sodium citrate)
Submission Container/Tube: Plastic vial, polypropylene preferred
Specimen Volume: 1 mL
Collection Instructions:
1. For complete instructions, see Coagulation Guidelines for Specimen Handling and Processing.
2. Within 4 hours of collection, centrifuge, transfer all plasma into a plastic vial, and centrifuge plasma again.
3. Aliquot plasma into separate plastic vial leaving 0.25 mL in the bottom of centrifuged vial.
4. Freeze plasma aliquot immediately at -20° C, or ideally, at -40° C or below.
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.
Specimen Type
Plasma Na CitWhole blood
Specimen Minimum Volume
Plasma: 0.5 mL; Whole blood: 3 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 |
Reject Due To
| Gross hemolysis | Reject |
| Gross lipemia | Reject |
| Gross icterus | Reject |
Reference Values
ACTIVATED PROTEIN C RESISTANCE V RATIO
≥2.3
Pediatric reference range has neither been established nor is available in scientific literature. The adult reference range likely would be applicable to children older than 6 months.
Interpretation
An activated protein C (APC) resistance ratio below 2.3 suggests abnormal resistance to APC of hereditary origin.
If the screening APC resistance test is abnormal, DNA-based testing for the factor V Leiden variant (p.Arg534Gln, formerly R506Q) is performed to confirm or exclude hereditary APC-resistance.
Day(s) Performed
Monday through Friday
Report Available
4 to 7 daysTest Classification
See Individual Test IDsCPT Code Information
85307
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| APCRR | APCRV, w/Reflex, P | 13590-5 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| APCR | APCRV Ratio | 13590-5 |
| SC018 | Whole Blood | No LOINC Needed |
| INT55 | Interpretation | 48591-2 |
Forms
1. New York Clients-Informed consent is required. Document on the request form or electronic order that a copy is on file. The following documents are available:
-Informed Consent for Genetic Testing (T576)
-Informed Consent for Genetic Testing-Spanish (T826)
2. Coagulation Patient Information (T675)
3. If not ordering electronically, complete, print, and send a Coagulation Test Request (T753) with the specimen.
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| APCRV | Activated Protein Resistance V, P | Yes | Yes |
| SC018 | Whole Blood | No | Yes |
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| F5DNA | Factor V Leiden (R506Q) Mutation, B | Yes | No |
| F5DNI | APCRV/F5DNA Summary Interpretation | No | No |
Testing Algorithm
If the assay ratio is abnormal, then factor V Leiden variant analysis will be performed at an additional charge.
When the activated protein C resistance V is abnormal or indeterminate and the factor V Leiden variant assay is performed, a summary interpretation will be provided.