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Test Code THRMP Thrombophilia Profile

Reporting Name

Thrombophilia Prof

Useful For

Evaluating patients with thrombosis or hypercoagulability states

 

Detecting a lupus-like anticoagulant; dysfibrinogenemia; disseminated intravascular coagulation/intravascular coagulation and fibrinolysis

 

Detecting a deficiency of antithrombin, protein C, or protein S

 

Detecting activated protein C resistance (and the factor V R506Q [Leiden] mutation if indicated)

 

Detecting the prothrombin G20210A mutation

Profile Information

Test ID Reporting Name Available Separately Always Performed
PTC Prothrombin Time (PT), P Yes, (order PTTP) Yes
APTTB Activated Partial Thrombopl Time, P Yes, (order APTTP) Yes
DRVT Dilute Russells Viper Venom Time, P Yes, (Order DRVTI) Yes
TT Thrombin Time (Bovine), P Yes Yes
FIBC Fibrinogen, P Yes, (order FIBTP) Yes
DIRM D-Dimer, P Yes, (order DDITT) Yes
SFM Soluble Fibrin Monomer No Yes
ATTF Antithrombin Activity, P Yes Yes
CFX Protein C Activity, P Yes Yes
PSF Protein S Ag, Free, P Yes, (order PSTF) Yes
PTNT Prothrombin G20210A Mutation, B Yes Yes
APCRV Activated Protein Resistance V, P Yes Yes
CCC Special Coagulation Interpretation No Yes

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
IBETH Bethesda Units No No
F8IS Coag Factor VIII Assay Inhib Scrn,P No No
ATTI Antithrombin Antigen, P Yes No
FACTV Coag Factor V Assay, P Yes No
F_7 Coag Factor VII Assay, P Yes No
F_9 Coag Factor IX Assay, P Yes No
F_10 Coag Factor X Assay, P Yes No
F_11 Coag Factor XI Assay, P Yes No
F_12 Coag Factor XII Assay, P Yes No
F8A Coag Factor VIII Activity Assay, P Yes No
RPTL Reptilase Time, P Yes No
F_2 Coag Factor II Assay, P Yes No
PCAG Protein C Ag, P Yes No
F5DNA Factor V Leiden (R506Q) Mutation, B Yes No
PNP Platelet Neutralization Procedure No No
PTMX PT Mix 1:1 No No
APTTM APTT Mix 1:1 No No
PST Protein S Ag, Total, P No No
STLA Staclot LA, P No No
DRVTM DRVVT Mix No No
DRVTC DRVVT Confirmation No No
S_FX Protein S Activity, P Yes No

Testing Algorithm

Initial testing includes: prothrombin time (PT); activated partial thromboplastin time (APTT); dilute Russells viper venom time (DRVVT); thrombin time (bovine); fibrinogen; D-dimer; soluble fibrin monomer; antithrombin activity; protein C activity; protein S antigen, free; prothrombin G20210A mutation; activated protein resistance V; and, if appropriate, special coagulation interpretation.

If PT is ≥14 seconds, PT mix will be performed.

If APTT is >36 seconds, APTT mix will be performed.

If APTT mix is >36 seconds with no evidence of heparin in samples, platelet neutralization procedure will be performed.

If DRVVT ratio is ≥1.2, DRVVT mix and DRVVT confirmation will be performed.

If thrombin time is >23 seconds, reptilase time will be performed.

If protein S antigen, free is <65% for males and females ≥50 years of age and <50% for females <50 years of age, protein S antigen, total will be performed.

If protein C activity is <70% with no evidence for an acquired decrease in protein C activity, protein C antigen may be performed.

If antithrombin activity is <80% with no evidence of an acquired decrease in antithrombin activity, antithrombin antigen will be performed.

If activated protein C resistance (APC) ratio is <2.3 or baseline APC APTT is prolonged, factor V leiden (R506Q) mutation analysis will be performed.

If appropriate, protein S activity, coagulation factor assays, or Staclot LA will be performed at an additional charge to clarify significant abnormalities in the screening clotting times.

If factor VIII result is <55%, the factor VIII inhibitor screen may be performed along with the Bethesda titering assay, if inhibitor screen is positive.

 

See Thrombophilia Profile algorithm in Special Instructions.

Method Name

PTC, PTMX, APTTB, APTTM, DRVT, TT, STLA, APCRV, DRVTM, DRVTC: Clot-Based Assay

FIBC: Clauss Methodology      

DIRM, PSF, PST: Automated Latex Immunoassay (LIA)

SFM: Immunoturbidimetric

ATTF, CFX: Chromogenic Assay

PTNT:  Direct Mutation Analysis

PNP: Activated Partial Thromboplastin Time (APTT) Mixing Test

Performing Laboratory

Mayo Medical Laboratories in Rochester

Specimen Type

Plasma Na Cit
Whole blood


Shipping Instructions


Send specimens in the same shipping container.



Specimen Required


See Coagulation Studies in Special Instructions.

 

Blood and plasma are required.

 

Specimen Type: Whole blood

Container/Tube: 

Preferred: Yellow top (ACD)

Acceptable: EDTA, sodium citrate

Specimen Volume: 6 mL

Collection Instructions:

1. Invert several times to mix blood.

2. Do not transfer blood to other containers.

3. Label specimen as whole blood.

 

Patient Preparation: 1. Patient should not be receiving Coumadin, heparin, direct thrombin inhibitors (argatroban, dabigatran), or direct factor Xa inhibitors (apixaban, rivaroxaban, and edoxaban).

2. Specimen must be drawn prior to initiation of anticoagulants and thrombolytic therapy.

Specimen Type: Platelet-poor plasma

Collection Container/Tube: Light-blue top (citrate)

Submission Container/Tube: Polypropylene vials

Specimen Volume: 6 mL in 6 Polypropylene vials each containing 1 mL

Collection Instructions:

 

1. Spin down, remove plasma, and spin plasma again.

2. Freeze specimens immediately at ≤-40 degrees C, if possible.

3. Label specimens as plasma.

Additional Information:

1. Double-centrifuged specimen is critical for accurate results as platelet contamination may cause spurious results.

2. If priority specimen, mark request form, give reason, and request a call-back.


Specimen Minimum Volume

Whole Blood: 3 mL; Plasma: 5 mL in 5 polypropylene vials each containing 1 mL

Specimen Stability Information

Specimen Type Temperature Time
Plasma Na Cit Frozen 14 days
Whole blood Ambient (preferred) 7 days
  Frozen  14 days
  Refrigerated  14 days

Reject Due To

Hemolysis

Mild OK; Gross reject

Lipemia

Mild OK; Gross reject

Icterus

Mild OK; Gross reject

Other

NA

Reference Values

An interpretive report will be provided.

Day(s) and Time(s) Performed

Monday through Friday

CPT Code Information

81240-F2 (prothrombin, coagulation factor II) (eg, hereditary hypercoagulability) gene analysis, 20210G->A variant

85300-AT activity

85303-Protein C activity

85306-Protein S antigen, free

85307-Activated protein resistance V

85366-Soluble fibrin monomer

85379-D-Dimer

85384-Fibrinogen

85390-26-Special coagulation interpretation

85610-PT       

85613-DRVVT

85670-Thrombin time

85730-APTT

81241-F5 (coagulation factor V) (eg, hereditary hypercoagulability) gene analysis, Leiden variant (if appropriate)

85210-Factor II (if appropriate)

85220-Factor V (if appropriate)

85230-Factor VII (if appropriate)

85240-Factor VIII (if appropriate)

85250-Factor IX (if appropriate)

85260-Factor X (if appropriate)

85270-Factor XI (if appropriate)

85280-Factor XII (if appropriate)

85301-Antithrombin antigen (if appropriate)

85302-Protein C antigen (if appropriate)

85305-Protein S antigen, total (if appropriate)

85306-Protein S activity (if appropriate)

85335-Bethesda titer (if appropriate)

85335-Factor VIII inhibitor screen (if appropriate)

85597-Platelet neutralization for lupus inhibitor (if appropriate)

85598-Staclot LA (if appropriate)

85611-PT mix 1:1 (if appropriate)

85613-DRVVT mix (if appropriate)

85613-DRVVT confirmation (if appropriate)

85635-Reptilase time (if appropriate)

85732-APTT mix 1:1 (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
THRMP Thrombophilia Prof In Process

 

Result ID Test Result Name Result LOINC Value
APTTB Activated Partial Thrombopl Time, P 14979-9
ATTF Antithrombin Activity, P 27811-9
CFX Protein C Activity, P 27818-4
FIBC Fibrinogen, P 3255-7
PSF Protein S Ag, Free, P 27821-8
SFM Soluble Fibrin Monomer 40702-3
TT Thrombin Time (Bovine), P 46717-5
APCR APCRV Ratio 13590-5
7525 Interpretation 69049-5
DDMDR Fibrinogen Equivalent Units (FEU) 48065-7
RVVR DRVVT Screen Ratio 15359-3
PR_TI Prothrombin Time (PT), P 5902-2
21803 Prothrombin G20210A Mutation, B 24475-6
21804 PTNT Interpretation 69049-5
INR2 INR 6301-6
DDIME D-Dimer Units (DDU) 48066-5
7769 Reviewed by: No LOINC Needed
INT55 Interpretation 48591-2
21806 PTNT Reviewed By No LOINC Needed

Forms

1. Coagulation Patient Information (T675) in Special Instructions

2. If not ordering electronically, complete, print, and send a Coagulation Test Request Form (T753) with the specimen (http://www.mayomedicallaboratories.com/it-mmfiles/coagulation-test-request-form.pdf)

3. New York Clients-Informed consent is required. Please document on the request form or electronic order that a copy is on file. An Informed Consent for Genetic Testing (T576) is available in Special Instructions.

Test Classification

See Individual Test IDs