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Activated Protein C-Resistance
Message*Take to processing ASAP to be spun down and froze
Test Code
22
Alias/See Also
LAB846
CPT Codes
85307
Preferred Specimen
2 mL frozen platelet-poor citrated plasma collected in a 3.2% sodium citrate (light-blue-top) tube
Minimum Volume
1 mL
Instructions
Platelet-poor plasma: Centrifuge light blue-top tube for 15 minutes at approximately 1500 g within 60 minutes 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. Plasma must be free of platelets (<10,000/mcL). Freeze immediately and ship on dry ice.
Transport Container
Transport tube
Transport Temperature
Frozen
Specimen Stability
Room temperature: Unacceptable
Refrigerated: Unacceptable
Frozen: 60 days
Refrigerated: Unacceptable
Frozen: 60 days
Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Gross hemolysis • Clotted specimen • Serum
Methodology
RVVT-based Assay (Clot-based)
Setup Schedule
Thurs
Report Available
1-8 days
Limitations
Expected impact by therapeutic levels (potential interference depends upon drug concentration): Warfarin: no effect; Heparin (UFH or LMWH): no effect; Dabigatran or Argatroban (Thrombin Inhibitors): unable to obtain assay endpoint; Rivaroxaban or Apixaban (Factor Xa Inhibitors): no effect.
Reference Range
≥2.1 Ratio
Clinical Significance
Activated protein C (APC) resistance is the most frequent hereditary defect associated with deep vein thrombosis. Over 95% of the APC resistance phenotype is due to the Factor V Leiden mutation. The APC-Resistance assay is a plasma based functional test for the determination of APC resistance caused by the factor V Leiden mutation.
Performing Laboratory
Quest Diagnostics Nichols Institute-San Juan Capistrano, CA |
33608 Ortega Highway |
San Juan Capistrano, CA 92675-2042 |