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PLATELET AUTOANTIBODY PANEL
Test Code14102
Alias/See Also
"Direct Platelet Antibodies
Platelet-associated Immunoglobulin
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Platelet-associated Immunoglobulin
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CPT Codes
86022(x3)
Includes
"Platelet-associated antibodies to platelet-specific glycoproteins IIb/IIIa, Ib/IX, and Ia/IIa
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Preferred Specimen
"Whole blood
12 mL (4 mL in each of three tubes)
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12 mL (4 mL in each of three tubes)
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Transport Container
"Lavender-top (EDTA) tube
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Transport Temperature
room temp
Specimen Stability
"Maintain specimen at room temperature
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Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
"Hemolysis; specimen more than 72 hour old
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Methodology
"Solid-phase enzyme-linked immunoassay after elution of antibodies from platelets "
Limitations
"This assay is not designed to detect antibodies associated with heparin-induced thrombocytopenia (HIT), the most common drug-induced immune thrombocytopenia. While a positive result is useful in supporting the diagnosis of ITP, negative results do not necessarily rule out the condition.
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Reference Range
"Negative
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Clinical Significance
"Detect the presence of an autoantibody that has been associated with autoimmune thrombocytopenic purpura (AITP)
Autoimmune thrombocytopenic purpura (AITP) occurs when platelet autoantibodies destroy an individual's platelets, resulting in a persistent thrombocytopenia.1 In children, AITP is usually self-limiting and frequently resolves spontaneously.2 AITP in children is often associated to a transient viral infection. Approximately 15% of childhood AITP cases become chronic.1 AITP in adults often has an insidious onset, resulting in chronic thrombocytopenia that rarely remits spontaneously.1,2 This condition can be idiopathic or, in some cases, associated with another autoimmune condition (ie, SLE) or malignancy.2
This platelet autoantibody panel is designed to detect IgG antibodies that are bound to platelet-specific glycoproteins llb/llla, lb/IX, or la/lla.3 Antibodies directed against endogenous platelet membrane antigens have been associated with AITP by several laboratories.3-8 A recent study reported that testing for platelet-associated antibodies to llb/llIa, lb/lX, and la/lla had a sensitivity of 53% and a specificity of 72% for diagnosing AITP.3 These results are consistent with the findings from previous studies showing sensitivity ranging from 49% to 66% and specificity ranging from 78% to 92% using assays to detect platelet-associated antibodies to platelet-specific glycoproteins llb/llla and lb/lX.4,5
Tests that measure antibodies to specific platelet antigens have been shown to provide clinical information that is superior to older assays that measured total platelet-associated immunoglobulin G; assays that have often been referred to as PAIgG assays.3-9 While PAIgG assays are frequently positive in patients with AITP, they are also often positive in patients with nonimmune thrombocytopenic disorders.5-9 In contrast to the older PAIgG assays, the platelet antigen specific panel has been shown to have a relatively high positive predictive value of 90%;3 however, the platelet antigen specific panel has been shown to have a low negative predictive value of 24%, indicating that a negative value should not be interpreted as ruling out the condition.3
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Autoimmune thrombocytopenic purpura (AITP) occurs when platelet autoantibodies destroy an individual's platelets, resulting in a persistent thrombocytopenia.1 In children, AITP is usually self-limiting and frequently resolves spontaneously.2 AITP in children is often associated to a transient viral infection. Approximately 15% of childhood AITP cases become chronic.1 AITP in adults often has an insidious onset, resulting in chronic thrombocytopenia that rarely remits spontaneously.1,2 This condition can be idiopathic or, in some cases, associated with another autoimmune condition (ie, SLE) or malignancy.2
This platelet autoantibody panel is designed to detect IgG antibodies that are bound to platelet-specific glycoproteins llb/llla, lb/IX, or la/lla.3 Antibodies directed against endogenous platelet membrane antigens have been associated with AITP by several laboratories.3-8 A recent study reported that testing for platelet-associated antibodies to llb/llIa, lb/lX, and la/lla had a sensitivity of 53% and a specificity of 72% for diagnosing AITP.3 These results are consistent with the findings from previous studies showing sensitivity ranging from 49% to 66% and specificity ranging from 78% to 92% using assays to detect platelet-associated antibodies to platelet-specific glycoproteins llb/llla and lb/lX.4,5
Tests that measure antibodies to specific platelet antigens have been shown to provide clinical information that is superior to older assays that measured total platelet-associated immunoglobulin G; assays that have often been referred to as PAIgG assays.3-9 While PAIgG assays are frequently positive in patients with AITP, they are also often positive in patients with nonimmune thrombocytopenic disorders.5-9 In contrast to the older PAIgG assays, the platelet antigen specific panel has been shown to have a relatively high positive predictive value of 90%;3 however, the platelet antigen specific panel has been shown to have a low negative predictive value of 24%, indicating that a negative value should not be interpreted as ruling out the condition.3
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