Antiphospholipid Syndrome Evaluation Panel with Reflexes

91248

Beta-2-Glycoprotein I Antibodies (IgG, IgA, IgM)
Phosphatidylserine/Prothrombin (PS/PT) Antibodies (IgG, IgM)
Cardiolipin Antibodies (IgA, IgG, IgM)
dRVVT Screen with Reflex to dRVVT Confirm and dRVVT 1:1 Mix

If dRVVT Screen is prolonged (>45 seconds), then dRVVT Confirm will be performed at an additional charge (CPT code(s): 85597).
If dRVVT Confirm is positive, then dRVVT 1:1 Mixing Study will be performed at an additional charge (CPT code(s): 85613).

⁠⁠⁠⁠⁠⁠⁠1 mL frozen platelet-poor plasma collected in each of three 3.2% sodium citrate (light blue-top) tubes

0.5 mL each specimen

Frozen

Room temperature: Unacceptable
Refrigerated: Unacceptable
Frozen: 30 days

Hemolysis • Grossly lipemic

The antiphospholipid antibody syndrome (APS) is a clinical-pathologic correlation that includes a clinical event (e.g. arterial or venous thrombosis, pregnancy morbidity) and persistent positive antiphospholipid antibodies (IgM, IgG Cardiolipin or b2GPI antibodies greater than the 99th percentile; or a lupus anticoagulant). International consensus guidelines for APS suggest waiting at least 12 weeks before retesting to confirm antibody persistence. The Systemic Lupus International Collaborating Clinics immunological classification criteria for systemic lupus erythematosus (SLE) include testing for isotype IgA, which has yet to be incorporated into APS criteria. Low level antiphospholipid antibodies may sometimes be detected in the setting of infection, drug therapy or aging.

Note: Target-specific anticoagulant therapy (anti-Xa medications, direct thrombin inhibitors) may cause false positive results for Lupus anticoagulant testing but do not impact the Cardiolipin, B2GPI and Phosphatidylserine-Prothrombin antibody testing.