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HelpTest Code ALUPP Lupus Anticoagulant Profile, Plasma
Additional Codes
Internal: 10501
External: LUPUS
Beaker: LAB4090
Ordering Guidance
Multiple coagulation profile tests are available. See Coagulation Profile Comparison for testing that is performed with each profile.
Shipping Instructions
Send the aliquots in the same shipping container.
Necessary Information
Note if patient is currently receiving anticoagulant (eg, heparin, Coumadin [warfarin]) treatment.
Specimen Required
Patient Preparation:
1. Patient should not be receiving anticoagulant treatment (eg, warfarin, heparin). Treatment with heparin causes false-positive results of in vitro coagulation testing for lupus anticoagulant. Coumadin (warfarin) treatment may impair ability to detect the more subtle varieties of lupus-like anticoagulants.
2. Patient should also not be receiving fibrinolytic agents (streptokinase, urokinase, tissue plasminogen activator: tPA).
3. If patient has been recently transfused, it is best to perform this study pretransfusion, if possible.
Specimen Type: Platelet-poor plasma
Collection Container/Tube: Light-blue top (citrate)
Submission Container/Tube: Plastic vials
Specimen Volume: 4 mL in 4 plastic vials each containing 1 mL
Collection Instructions:
1. Specimen must be collected prior to factor replacement therapy.
2. For complete instructions, see Coagulation Guidelines for Specimen Handling and Processing.
3. Centrifuge, transfer all plasma into a plastic vial, and centrifuge plasma again.
4. Aliquot plasma (1-2 mL per aliquot) into 4 separate plastic vials, leaving 0.25 mL in the bottom of centrifuged vial.
5. Freeze plasma immediately (no longer than 4 hours after collection) at -20° C or, ideally, -40° C or below.
Additional Information:
1. Double-centrifuged specimen is critical for accurate results as platelet contamination may cause spurious results.
2. Each coagulation assay requested should have its own vial.
Forms
1. Coagulation Patient Information (T675)
2. If not ordering electronically, complete, print, and send a Coagulation Test Request (T753) with the specimen.
Secondary ID
603463Useful For
Confirming or excluding the presence of lupus anticoagulant (LA), distinguishing LA from specific coagulation factor inhibitors and nonspecific inhibitors
Investigating a prolonged activated thromboplastin time, especially when combined with other coagulation studies
This test is not useful for the detection of antiphospholipid antibodies that do not affect coagulation tests. We recommend separate testing for serum phospholipid (cardiolipin), IgG and IgM (CLPMG) and beta-2 glycoprotein 1, IgG and IgM (B2GMG).
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| ALUPI | Lupus Anticoagulant Tech Interp | No | Yes |
| PTSC | Prothrombin Time (PT), P | Yes, (order PTTP) | Yes |
| APTSC | Activated Partial Thrombopl Time, P | Yes, (order APTTP) | Yes |
| DRV1 | Dilute Russells Viper Venom Time, P | Yes, (order DRVI1) | Yes |
Testing Algorithm
Initial testing includes prothrombin time (PT), activated partial thromboplastin time (aPTT), and dilute Russell's viper venom time (dRVVT).
If the PT, aPTT, and dRVVT are normal, a computer-generated interpretive comment indicating no evidence of a lupus anticoagulant (LA) will be provided.
If PT is greater than 13.9 seconds, PT mix will be performed at an additional charge.
If aPTT is greater than or equal to 38 seconds, aPTT mix will be performed at an additional charge.
If PT, aPTT, or dRVVT are prolonged, thrombin time (TT) will be performed at an additional charge.
If aPTT mix is greater than or equal to 38 seconds and thrombin time is less than 35.0 seconds (no evidence of heparin), platelet neutralization procedure will be performed at an additional charge.
If dRVVT ratio is greater than or equal to 1.20, dRVVT mix and dRVVT confirmation will be performed at an additional charge.
If TT is greater than or equal to 25.0 seconds, reptilase will be performed at an additional charge.
If appropriate, coagulation factor assays, fibrinogen, D-dimer, hexagonal LA, and soluble fibrin monomer will be performed, at an additional charge, to clarify a significant abnormality in the screen test results.
If the factor VIII, IX or V result is below the normal range, the factor inhibitor screen may be performed along with the Bethesda titering assay, if indicated, at an additional charge.
If any test results are abnormal, all results will be reviewed by a coagulation consultant and a lupus anticoagulant interpretation will be provided.
For more information see Lupus Anticoagulant Profile Testing Algorithm.
Special Instructions
Method Name
PTSC, APTSC, DRV1: Optical Clot-Based
Reporting Name
Lupus Anticoagulant ProfSpecimen Type
Plasma Na CitSpecimen Minimum Volume
3 mL in 3 plastic vials each containing 1 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Plasma Na Cit | Frozen | 14 days |
Reject Due To
| Gross hemolysis | Reject |
| Gross lipemia | Reject |
| Gross icterus | Reject |
Reference Values
An interpretive report will be provided.
Day(s) Performed
Monday through Friday
Report Available
3 to 5 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Test Classification
See Individual Test IDsCPT Code Information
85610
85730
85613
85390
85130 (if appropriate)
85130 (if appropriate)
85210 (if appropriate)
85220 (if appropriate)
85230 (if appropriate)
85240 (if appropriate)
85245 (if appropriate)
85246 (if appropriate)
85247 (if appropriate)
85250 (if appropriate)
85260 (if appropriate)
85270 (if appropriate)
85280 (if appropriate)
85335 (if appropriate)
85335 (if appropriate)
85335 (if appropriate)
85366 (if appropriate)
85379 (if appropriate)
85384 (if appropriate)
85385 (if appropriate)
85390-26 (if appropriate)
85397 (if appropriate)
85597 (if appropriate)
85598 (if appropriate)
85611 (if appropriate)
85613 (if appropriate)
85613 (if appropriate)
85635 (if appropriate)
85670 (if appropriate)
85732 (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| ALUPP | Lupus Anticoagulant Prof | 75881-3 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| RVR1 | DRVVT Screen Ratio | 15359-3 |
| PTSEC | Prothrombin Time (PT), P | 5902-2 |
| APTSC | Activated Partial Thrombopl Time, P | 14979-9 |
| ALUPI | Lupus Anticoagulant Tech Interp | 75882-1 |
| INRSC | INR | 6301-6 |
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| DIMER | D-Dimer, P | Yes, (order DDITT) | No |
| F8IS | Coag Factor VIII Assay Inhib Scrn,P | No | No |
| FACTV | Coag Factor V Assay, P | Yes | No |
| F_7 | Coag Factor VII Assay, P | Yes | No |
| TTSC | Thrombin Time (Bovine), 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 |
| RTSC | Reptilase Time, P | Yes | No |
| F_2 | Coag Factor II Assay, P | Yes | No |
| CLFIB | Fibrinogen, Clauss, P | Yes, (order FIBTP) | No |
| SOLFM | Soluble Fibrin Monomer | No | No |
| PNP | Platelet Neutralization Procedure | No | No |
| PTMSC | PT Mix 1:1 | No | No |
| APMSC | APTT Mix 1:1 | No | No |
| DRV2 | DRVVT Mix | No | No |
| DRV3 | DRVVT Confirmation | No | No |
| ALUPO | Lupus Anticoagulant Interp | No | No |
| RIST | Ristocetin Cofactor, P | No | No |
| F5_IS | Factor V Inhib Scrn | No | No |
| VWFMP | von Willebrand Factor Multimer, P | Yes, ( order VWFMS ) | No |
| PTFIB | PT-Fibrinogen, P | Yes | No |
| VWAG | von Willebrand Factor Ag, P | Yes | No |
| VWACT | von Willebrand Factor Activity, P | Yes | No |
| CH9 | Chromogenic FIX, P | Yes | No |
| 5BETH | FV Bethesda Units, P | No | No |
| F9_IS | Factor IX Inhib Scrn | No | No |
| 8BETH | FVIII Bethesda Units, P | No | No |
| 9BETH | FIX Bethesda Units, P | No | No |
| CHF8 | Chromogenic FVIII, P | Yes | No |
| HEXLA | HEX LA, P | No | No |