Protein C Activity and Antigen

Message
*Take to Processing ASAP.
3.2% Sodium Citrate (light blue tube): Pour 1.0 mL in TWO separate vials (2.0 mL total). Freeze.


Test Code
8757


Alias/See Also
LAB490


CPT Codes
85302, 85303

Preferred Specimen
2 mL frozen plasma (1 mL in two separate tubes) collected in a 3.2% sodium citrate (light blue-top) tube


Minimum Volume
0.5 mL (x2)


Instructions
Please submit a separate, frozen vial for each special coagulation assay ordered. Draw blood in a light
blue-top tube containing 3.2% sodium citrate, mix gently by inverting 3-4 times. Centrifuge 15 minutes at
1500 g within one hour of collection. Using a plastic pipette, remove plasma, taking care to avoid the
WBC/platelet buffy layer and place into a plastic vial. Centrifuge a second time and transfer platelet-poor
plasma into a new plastic vial(s). Freeze immediately and transport on dry ice.


Transport Container
Transport tubes (x2)


Transport Temperature
Frozen


Specimen Stability
Room temperature: Unacceptable
Refrigerated: Unacceptable
Frozen: 14 days


Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Gross hemolysis


Methodology
Clotting Assay • Immunoassay (IA)

Limitations
Protein C, Activity: Expected impact by therapeutic levels (potential interference depends upon drug concentration): Warfarin: decrease; Heparin (UFH or LMWH): UFH-no effect, LMWH-may falsely increase at higher levels; Dabigatran or Argatroban (Thrombin Inhibitors): may falsely increase; Rivaroxaban or Apixaban (Factor Xa Inhibitors): may falsely increase.

Protein C, Antigen: Expected impact by therapeutic levels (potential interference depends upon drug concentration): Warfarin: no effect to decrease; Heparin (UFH or LMWH): no effect; Dabigatran or Argatroban (Thrombin Inhibitors): no effect; Rivaroxaban or Apixaban (Factor Xa Inhibitors): no effect.


Reference Range
Protein C Activity70-180 % normal
Protein C Antigen70-140 % normal


Clinical Significance
Aids in characterization of protein C deficiency. Type I deficiency is characterized by reduction in activity (functional) and antigen levels. With type II deficiency (dysfunctional protein), antigen levels may be normal and activity levels are decreased. Acquired deficiencies may occur with vitamin K antagonists/deficiency, liver disease, malignancy, consumptive DIC, surgery, trauma, and hepatic immaturity of the newborn. Drug therapy with L-asparaginase or fluorouracil can also reduce Protein C antigen levels.

Anticoagulant interference: Expected impact by therapeutic levels (potential interference depends upondrug concentration): Vitamin K Antagonists (eg. coumadin): decrease; Heparin (UFH or LMWH): no effect to falsely increased activity levels at higher levels; Dabigatran or Argatroban (Direct Thrombin Inhibitors): may falsely increase activity; Rivaroxaban, Apixaban, Edoxaban (Factor Xa Inhibitors): may falsely increase activity.


Performing Laboratory
Quest Diagnostics Nichols Institute-San Juan Capistrano, CA
33608 Ortega Highway
San Juan Capistrano, CA 92675-2042




The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.