Test Code Billings Clinic: 2081 Antiphospholipid Syndrome Panel
Performing Laboratory
Billings Clinic Laboratory: Immunology, Coagulation
Useful For
Useful for identifying and distinguishing lupus anticoagulants from anticardiolipin antibodies.
- Antiphospholipid antibodies are present in 0% to 5% of the general population and in 12% or more of patients with thrombosis.
- These antibodies are associated with an increased risk for arterial or venous thrombosis, thrombocytopenia, and fetal loss.
- Associations with cardiac valve disease, livedo reticularis, and other features are also recognized.
- In a recent prospective study involving individuals with antiphospholipid antibodies, the incidence of thrombosis per year was 1% in individuals with no history of thrombosis, 4% in patients with systemic lupus erythematous, 5.5% in patients with a history of thrombosis, and 6% in individuals with high titer IgG anticardiolipin antibody (>40 units).
Methodology
Chemiluminescent Immunoassay - beta-2 glycoprotein 1 antibody, IgG and IgM; phospholipid antibodies (cardiolipin antibodies), IgG and IgM
Optical - DRVVT
Specimen Requirements
See “Coagulation Studies—Billings Clinic Laboratory” under "Resources"
Sodium citrate plasma and serum are required for this test.
Plasma for DRVVT
- Draw blood in a light blue-top (3.2% sodium citrate) tube(s).
- Immediately after draw, gently invert tube(s) at least 6 times to mix well.
- Spin down, remove plasma, spin plasma again, and place 2 mL of citrate, platelet-poor plasma into 2 plastic vials each containing 1 mL.
- Label specimen appropriately (plasma).
- Glass vial is not acceptable.
- Freeze specimen immediately at -20° C.
- Send specimen frozen.
- Double-centrifuged specimens are critical for accurate results as platelet contamination may cause spurious results.
- Patient should not be on Coumadin® or heparin.
- Correction of the anticoagulant to blood ratio is required for patient hematocrits >55% for the light blue-top tube.
Serum for All Other Tests
- Draw blood in a plain, red-top tube(s) or a serum gel tube(s).
- Spin down and send 1 mL of serum frozen in plastic vial.
- Label specimen appropriately (serum for all other tests).
Storage/Stability
Specimen Type | Temperature | Time |
Serum | Refrigerated | 48 hours |
Frozen (preferred) | 1 year | |
Ambient (spun) | 8 hours |
Reject Due To
- Gross Hemolysis
- Gross Lipemia
- Gross Icterus
Reference Values
Reference values are included with patient’s report.
Day(s) Test Set Up
Saturday: DRVVT
Friday: beta-2 glycoprotein 1 antibody, IgG and IgM; phospholipid antibodies (cardiolipin antibodies), IgG; phospholipid antibodies (cardiolipin antibodies), IgM
Test Classification and CPT Coding
85612 - DRVVT; undiluted
85613 - DRVVT; diluted (if appropriate)
86146 X 2 - beta-2 glycoprotein 1 antibody, IgG and IgM
86147 x 2 - phospholipid antibodies (cardiolipin antibodies), IgG and IgM
LOINC Code Information
Reporting Name | LOINC Code |
Beta-2-Glycoprotein 1 IgG, Ab | 44448-9 |
Beta-2-Glycoprotein 1 IgM, Ab | 44449-7 |
Anti-Cardiolipin Ab, IgG | 3181-5 |
Anti-Cardiolipin Ab, IgM | 3182-3 |
DRVVT Screen | 6303-2 |
DRVVT Confirm(as appropriate) | 57838-5 |
Profile/Testing Information
Profile Information: | |
Beta-2 Glycoprotein 1 Antibody, IgM | Phospholipid Antibodies (Cardiolipin Antibodies), IgG |
Beta-2 Glycoprotein 1 Antibody, IgG | Phospholipid Antibodies (Cardiolipin Antibodies), IgM |
Dilute Russell’s Viper Venom Time (DRVVT) | |
Reflex Tests (at an additional charge): | |
DRVVT Confirmation | DRVVT Mixing Study 1:1 |
DRVVT Confirmation 1:1 |
Reflex Information:
This test may automatically reflex to other tests. An additional fee may be added.
The ordering physician/provider must indicate if the reflex test is NOT DESIRED. Indicate on order if no reflex test is desired.