Antithrombin III Antigen

Test Code
AT3B


Quest Code
5158


CPT Codes
85301

Preferred Specimen
1 mL frozen platelet-poor plasma collected in 3.2% sodium citrate (light blue-top) tube


Minimum Volume
0.5 mL


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 Temperature

Frozen



Specimen Stability
Room temperature: Unacceptable
Refrigerated: Unacceptable
Frozen: 30 days


Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Gross hemolysis • Grossly lipemic • Grossly icteric


Methodology
Immunoturbidimetric

Setup Schedule
Sets up 4 days a week.


Report Available
Reports in 1 to 3 days.


Limitations
Expected impact by therapeutic levels (potential interference depends upon drug concentration): Warfarin: no effect; Heparin (UFH or LMWH): no effect to decrease (UFH may decrease levels physiologically but no assay interference); Dabigatran or Argatroban (Thrombin Inhibitors): no effect; Rivaroxaban or Apixaban (Factor Xa Inhibitors): no effect.


Reference Range
80-120 % normal


Clinical Significance
Aids in characterization of Antithrombin deficiency (AT, previously referred to as Antithrombin III) which is associated with increased thrombotic risk. Type I deficiency is characterized by reduction in activity and antigen levels simultaneously. With type II deficiency, activity levels are lower in comparison to the antigen levels (dysfunctional protein). Acquired deficiency, more common than inherited defects, can occur due to: liver disease, nephrotic syndrome, heparin therapy, disseminated intravascular coagulation (DIC), sepsis, and L-asparaginase chemotherapy.

Anticoagulant interference: heparin therapy may lower AT levels. Other anticoagulants do not impact testing (warfarin, target specific anticoagulants such as Dabigatran, Argatroban, Rivaroxaban, Apixaban, Edoxaban).


Performing Laboratory
Quest Diagnostics Nichols Institute
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.