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Reptilase Clotting Time
Test CodeQuest Code
CPT Codes
85635
Preferred Specimen
Minimum Volume
Instructions
Draw blood in light blue-top tube containing 3.2% sodium citrate (light blue-top) tube, and mix gently by inverting 3-4 times. Centrifuge 15 minutes at 1500 x g within 1 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 Temperature
Specimen Stability
Refrigerated: Unacceptable
Frozen -20°C: 30 days
Frozen -70°C: > 30 days
Methodology
Clot Based Assay
Setup Schedule
Reference Range
Clinical Significance
In patients with prolonged clotting times, this test may help diagnose dysfibrinogenemia or exclude heparin contamination. In heparinized or hemophiliac patients, this test may be used in conjunction with or instead of thrombin time to help diagnose congenital and acquired disorders of fibrinogen [1].
Reptilase is a venom enzyme from Bothrops snakes and has thrombin-like activity. Reptilase time is often used in conjunction with thrombin time to detect anomalies of fibrinogen. These anomalies can be congenital (eg, dysfibrinogenemia, hypofibrinogenemia, afibrinogenemia) or acquired (eg, hypofibrinogenemia as a result from disseminated intravascular coagulation or liver disease). In patients with abnormal clotting times, thrombin time and reptilase time can help screen for dysfibrinogenemia [2]. Because reptilase time is insensitive to thrombin inhibitors (eg, heparin or hirudin), it can be used to determine heparin contamination in patients with prolonged clotting times [1]. A prolonged thrombin time and a normal reptilase time generally indicate heparin contamination.
Note that reptilase time may be slightly prolonged in healthy newborns [1].
The results of this test should be interpreted in the context of pertinent clinical and family history and physical examination findings.
References
1. Cunningham MT, et al. Arch Pathol Lab Med. 2002;126(4):499-505.
2. Karapetian H. Methods Mol Biol. 2013;992:273-277.
Performing Laboratory
Quest Diagnostics Nichols Institute
14225 Newbrook Dr
Chantilly, VA 20153
Last Updated: August 26, 2019