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Lupus Anticoag Eval Reflx 7079

Test Code
LUPA


Alias/See Also
LUPA


CPT Codes
85613;85730

Includes
PTT-LA and dRVVT with Reflex Confirmations


Preferred Specimen
1.5 mL frozen platelet-poor plasma (x2) collected in separate 3.2% sodium citrate (light blue-top) tubes


Minimum Volume
1


Instructions
Draw 4 light blue and send plasma frozen


Transport Container
BLUE


Transport Temperature
F


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


Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Hemolysis • Received thawed


Methodology
Clot detection

Setup Schedule
Set up: Mon-Fri; Report available: 1-4 days


Limitations
Expected impact by therapeutic levels (potential interference depends upon drug concentration): Warfarin: no effect (panel includes mixing studies which correct for Warfarin-induced factor deficiencies); Heparin (UFH or LMWH): possible to misclassify as LA; Dabigatran or Argatroban (Thrombin Inhibitors): panel includes Thrombin Time (TT) which detects thrombin inhibitors, unable to detect if TT significantly abnormal; Rivaroxaban or Apixaban (Factor Xa Inhibitors): possible to misclassify as LA.


Reference Range
Lupus Anticoagulant Not detected
PTT-LA Screen ≤40 sec
dRVVT Screen ≤45 sec


Clinical Significance

Lupus anticoagulants (LA) are members of a family of antibodies with phospholipid-protein specificity. LA may be defined as an immunoglobulin, IgG or IgM or a mixture of both, that interferes with one or more of the in-vitro phospholipid (PL) dependent tests of coagulation. These antibodies are not associated with a hemorrhagic diathesis, but rather have been linked to thrombotic events. In addition to thrombosis other clinical complications have been associated with the presence of LA. These include strokes, nonbacterial thrombotic endocarditis, livedo reticularis and a variety of obstetrical complications such as intrauterine fetal death, recurrent spontaneous abortion, fetal growth retardation, early onset preeclampsia and chorea gravidarum.

Note: Target specific anticoagulant therapy (anti-Xa medications, direct thrombin inhibitors) may cause false positive results.



Performing Laboratory
Quest Diagnostics Nichols Institute
14225 Newbrook Drive
Chantilly, VA 20153




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.